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Gender / Cardiovascular Disease in Women

Landmark Article

Association of sex hormones and sex hormone-binding globulin with depressive symptoms in postmenopausal women: the Multi-ethnic Study of Atherosclerosis.
By: Colangelo LA, Craft LL, Ouyang P, Liu K, Schreiner PJ, Michos ED, Gapstur SM.
In early postmenopausal women, sex hormones were associated with incident depressive symptoms.
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Gender differences in coronary plaque composition and burden detected in symptomatic patients referred for coronary computed tomographic angiography.
By: Qureshi W, Blaha MJ, Nasir K, Al-Mallah MH.
Symptomatic women have a lower prevalence of obstructive coronary artery disease and are less likely to have mixed coronary plaque compared to symptomatic men. Future studies are needed to determine the prognostic implications of these findings.
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Health disparities in endocrine disorders: Biological, clinical, and nonclinical factors — an Endocrine Society Scientific Statement.
By: Golden SH, Brown A, Cauley JA, Chin MH, Gary-Webb TL, Kim C, Sosa JA, Sumner AE, Anton B.
There is little evidence that genetic differences contribute significantly to race/ethnic disparities in the endocrine disorders examined. Multilevel interventions have reduced disparities in diabetes care, and these successes can be modeled to design similar interventions for other endocrine diseases.
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Comparison of breast cancer recurrence risk and cardiovascular disease incidence risk among postmenopausal women with breast cancer.
By: Bardia A, Arieas ET, Zhang Z, Defilippis A, Tarpinian K, Jeter S, Nguyen A, Henry NL, Flockhart DA, Hayes DF, Hayden J, Storniolo AM, Armstrong DK, Davidson NE, Fetting J, Ouyang P, Wolff AC, Blumenthal RS, Ashen MD, Stearns V.
Competing comorbidities, particularly cardiovascular disease (CVD), should be considered when individualizing adjuvant therapies for postmenopausal women diagnosed with breast cancers. Among postmenopausal women with hormone receptor-positive (HR+), non-metastatic breast cancer, the majority had a predicted 10-year CVD risk that was equivalent to or higher than breast cancer recurrence risk. Physicians should weigh competing risks and offer early screening and cardiac prevention strategies for women at a greater risk for CVD.
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Association of baseline sex hormone levels with baseline and longitudinal changes in waist-to-hip ratio: Multi-Ethnic Study of Atherosclerosis.
By: Vaidya D, Dobs A, Gapstur SM, Golden SH, Cushman M, Liu K, Ouyang P.
Sex hormones are associated with waist-to-hip ratio at baseline and also during follow-up above and beyond their baseline association. Future research is needed to determine if manipulation of hormones is associated with changes in central obesity.
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Sex-steroid hormones and electrocardiographic QT-interval duration: Findings from the Third National Health and Nutrition Examination Survey and the Multi-Ethnic Study of Atherosclerosis.
By: Zhang Y, Ouyang P, Post WS, Dalal D, Vaidya D, Blasco-Colmenares E, Soliman EZ, Tomaselli GF, Guallar E.
The association between physiologic levels of sex hormones and QT-interval duration in humans was evaluated using data from 727 men enrolled in the Third National Health and Nutrition Examination Survey and 2,942 men and 1,885 postmenopausal women enrolled in MESA. Testosterone, estradiol, and sex hormone-binding globulin levels were measured in serum and free testosterone was calculated from those values. The findings suggest that testosterone levels may explain differences in QT-interval duration between men and women and could be a contributor to population variability in QT-interval duration among men.
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The association of bone density and calcified atherosclerosis is stronger in women without dyslipidemia: The multi-ethnic study of atherosclerosis.
By: Jensky NE, Hyder JA, Allison MA, Wong N, Aboyans V, Blumenthal RS, Schreiner P, Carr JJ, Wassel CL, Ix JH, Criqui MH.
We tested whether the association between bone mineral density (BMD) and CAC varies according to dyslipidemia in community-living individuals. The inverse association of BMD with CAC proved stronger in women without dyslipidemia. These data argue against the hypothesis that dyslipidemia is the key factor responsible for the inverse association of BMD with atherosclerosis.
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Sex differences in subclinical atherosclerosis by race/ethnicity in the multi-ethnic study of atherosclerosis.
By: Kim C, Diez-Roux AV, Nettleton JA, Polak JF, Post WS, Siscovick DS, Watson KE, Vahratian AM.
Sex differences in CVD mortality are more pronounced among non-Hispanic whites than other racial/ethnic groups, but it is unknown whether this variation is present in the earlier subclinical stages of disease. The authors examined racial/ethnic variation in sex differences in CAC and cIMT at baseline in 2000-2002 among participants (n = 6,726) in MESA using binomial and linear regression. Models adjusted for risk factors in several stages: age, traditional cardiovascular disease risk factors, behavioral risk factors, psychosocial factors, and adult socioeconomic position. In conclusion, coronary artery calcification is differentially patterned by sex across racial/ethnic groups.
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Relationships of mitral annular calcification to cardiovascular risk factors: the Multi-Ethnic Study of Atherosclerosis (MESA).
By: Kanjanauthai S, Nasir K, Katz R, Rivera JJ, Takasu J, Blumenthal RS, Eng J, Budoff MJ.
The relationship between MAC, a fibrous, degenerative calcification of the mitral valve, and CVD risk factors is not well defined. Thus, we performed a cross-sectional study to determine which CVD risk factors are independently associated with MAC. We concluded that age, female gender, diabetes, and increased BMI were significantly associated with MAC. Prevalence of MAC was strongly associated with female gender and increasing age in all ethnicities.
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Statin therapy in primary prevention: New insights regarding women and the elderly.
By: Harrington C, Horne A Jr., Hasan R, Blumenthal RS.

Cardiovascular disease (CVD) remains the leading cause of death in men and women in the United States and is a leading cause of disability. Advances in pharmacotherapy and revascularization strategies have resulted in a decrease in mortality and an improvement of quality of life. The emphasis on primary and secondary prevention is imperative to provide high-quality and cost-effective medical care that will improve survival and quality of life.

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