When it comes to heart disease, women and men are not equal

When C. Noel Bairey Merz, MD, became a cardiologist, she quickly learned that heart disease studies focused on male patients, while women were widely viewed as though they were smaller versions of men.

Times have changed.

Online videos

Dr. C. Noel Bairey Merz was a featured guest on The Dr. Oz Show, a popular, national program carried on Fox. Click on these links to see three excerpts from the show:

Here are links to four Dr. Oz "web exclusives" - "Heart disease and what women need to know" - with Dr. Bairey Merz:

Bairey Merz, the director of the Women's Heart Center at the Cedars-Sinai Heart Institute, says recent research has shown that women who have heart disease experience different symptoms, causes and outcomes than men. She believes that each gender's heart ailments deserve different names. "We are just at the beginning of understanding the differences between the sexes when it comes to heart disease," says Bairey Merz. "The more we find out, the more it becomes clear that men and women can experience different diseases and the medical names for those diseases should reflect the differences. There is enough research to conclude that women and men can experience different types of heart disease.

Bairey Merz believes women's heart disease should be referred as ischemic heart disease. Ischemia is a term that indicates a lack of blood flow and oxygen to the heart, resulting in symptoms such as chest discomfort, shortness of breath and nausea. Women with ischemic heart disease generally have major arteries that are clear of plaque, but the smaller coronary blood vessels cease to constrict and dilate properly, creating the lack of blood flow and oxygen to the heart.

The type of heart ailment that generally affects men should continue to be called coronary artery disease (CAD) or coronary heart disease (CHD), Bairey Merz says, because men more often suffer from plaque build-up in the large arteries around the heart.

Some of the key findings that point out the heart disease differences between men and women include:

  • Women who have a history of irregular menstrual cycles, estrogen deficiencies and polycystic ovary syndrome may have a higher risk of developing heart disease as they age.
  • Women can have normal angiograms even when they have ischemic heart disease.
  • Women are often told their stress tests are normal or that they have "false positives." Bairey Merz says doctors should pay attention to symptoms such as chest pain and shortness of breath rather than relying on a stress test score.
  • Women who exhibit symptoms of ischemic heart disease can benefit from treatments ranging from proper medication to reduce heart attacks and control symptoms, as well as lifestyle changes, such as losing weight, eating a low-fat diet and exercising regularly.

"We are just at the beginning of understanding the differences between the sexes when it comes to heart disease," Bairey Merz said. "What we need now are large-scale medical studies that identify tailored diagnostic and therapeutic strategies to optimize outcomes for women and men."