Men and women are very different when it comes to heart disease. One well-known difference is that women historically have developed heart issues later in life than men because estrogen is protective up until menopause.
But as women age, they actually show increased rates of stroke and cardiovascular disease risk factors such as high blood pressure as compared to men. The overall number of women living and dying with cardiovascular disease and stroke now exceeds that of men, as does the number of hospital discharges for heart failure and stroke, according to the American Heart Association.
Moreover, the premenopausal protection against heart disease provided younger women by estrogen is disappearing as rates of diabetes and obesity rise among those who are premenopausal.
“Obesity is a huge problem and is growing rapidly and more women are obese than are men,” said Iris Jaffe, MD, PhD,
Executive Director of the Molecular Cardiology Research Institute
(MCRI) at Tufts Medical Center in Boston. “Women with diabetes, a common complication of obesity, lose the protection that being young and female provides them.”
Taking a closer look
MCRI is studying the differences in heart disease at the molecular level between men and women with the goal of finding gender-specific treatments that are more personalized than are currently available.
“If we can’t reverse obesity, maybe we can prevent it from causing cardiovascular side effects, stroke, heart attacks and death,” she said.
Dr. Jaffe noted that heart disease deaths among women in the 35 to 54-year-old age group are on the rise at a time when overall heart disease deaths are dropping due to advances in care. “It is a new trend that is concerning,” she said.
One area the Institute is studying is how obesity affects blood vessels to cause heart disease. Studies in mice show that vessels in obese mice become dysfunctional, but in different ways in male mice than in female mice. “We are looking at the underlying molecular mechanisms in the males compared to the females. The way they become dysfunctional is totally different.”
It is hoped that the work will result in the development of gender-specific drugs to treat impaired blood vessels, she said. Her study will soon be published in the Journal of the American Heart Association.
The aging heart
Another study just getting underway is being led by Jennifer DuPont, PhD
, an investigator at the Institute and assistant professor of medicine at Tufts Medical School. Funded with a $285,000 grant from the National Institutes of Health, the study will look at mechanisms and factors that contribute to cardiovascular dysfunction and blood vessel stiffening that occurs with aging. Among areas to be studied are specific genes in the blood vessels that contribute to vascular aging, looking for differences between men and women.
The work also could result in the development of gender-specific drugs to treat the problem.
The study will at first be done in mouse models but studies on human vascular function are also planned.
The Molecular Cardiology Research Institute was created in 1998 and investigators from the institute published some of the first studies showing that estrogen acts directly on the heart and blood vessels to protect females from heart disease.