Summary: Cardiology Guidelines Must Be Sex-Specific for Female Heart Patients
Summary: Cardiology Guidelines Must Be Sex-Specific for Female Heart Patients
Highlighted: June 17, 2025 – in an expert cardiology update
Featuring insights from Dr. Janet Wei, Cedars-Sinai Heart Institute.
1. Women’s Heart Disease Requires Distinct Guidelines
• Cardiovascular disease (CVD) remains the leading cause of death among women.
• Current clinical guidelines are largely based on male data, overlooking sex-specific presentations and risk factors.
• Dr. Janet Wei (Cedars-Sinai) urges separate, sex-specific guidelines to address women’s unique cardiovascular needs.
2. Unique Risk Factors and Disease Patterns in Women
• Traditional risk factors don’t fully account for female-specific enhancers such as:
• Early menopause
• Pregnancy-related complications (e.g., preeclampsia)
• Premature menopause or adverse outcomes
• Pregnancy acts as a natural cardiovascular stress test, unmasking latent heart conditions.
3. Different Disease Mechanisms and Presentations
• Women are more prone to:
• MINOCA (Myocardial Infarction with Non-Obstructive Coronary Arteries)
• Microvascular dysfunction, vasospasm, and plaque erosion
• Misdiagnosis is common due to atypical symptoms and absence of obstructive coronary lesions.
4. Rising Mortality in Younger Women
• Women typically present with CVD about 10 years later than men, partly due to estrogen’s protective effects.
• However, CVD mortality is rising again, especially in women under 55.
• Highlights the need for early risk assessment, particularly in women with adverse reproductive histories.
5. Differences in Treatment Response
• Women have:
• Higher bleeding risk post-MI or surgery
• Better outcomes with less invasive procedures (e.g., radial access)
• Sex-specific planning is needed for interventions like TAVR valve sizing and antithrombotic therapy.
6. New Evidence with Emerging Therapies
• Women respond more significantly to GLP-1 receptor agonists, with greater weight loss than men.
• Ongoing research is exploring how these differences may affect cardiovascular outcomes.
7. Call to Action: Sex-Specific Guidelines
• Dr. Wei and other experts call on societies like ACC and AHA to:
• Develop dedicated female cardiovascular guidelines
• Incorporate hormonal stages (pre-, peri-, post-menopause) into treatment plans
• The future of cardiology must embrace individualized, sex-based care models.
