Abstract
This report addresses the medical components of coronary heart disease (CHD) in women, its presentation and clinical outcomes, and the coronary risk factors important for women. The information should buttress the need to identify the psychosocial components or contributors that relate to CHD because it will become evident that women have less favorable outcomes once CHD becomes clinically manifest than do their male counterparts.
The data presented here derive from information gathered in the United States. Although this information can, in part, be extrapolated to other countries, specific incidence and outcome variables require validation in different populations, particularly where CHD rates are low. Coronary disease, the medical problem that results in myocardial infarction (MI), is the major cause of mortality among women in the United States, accounting for almost 250,000 deaths annually. However, when one examines the information used in regard to prevention, to clinical features, and to therapy and prognosis of CHD in women, it is based on studies in populations that involved predominantly or exclusively middle-aged men. It has yet to be ascertained how much of this middle-aged male model of CHD is applicable to the older women in whom CHD occurs.
Introduction
Age is an important factor in women regarding CHD. Whereas one in eight or nine women in the 45-64-year age group has clinical evidence of CHD, this is present in one in three women older than 65 years of age. What must be addressed, therefore, is the combination of both a female incidence and prevalence of coronary disease and an elderly age incidence and prevalence of coronary disease; often the two may not be separable.
Angina Pectoris
As with much of the epidemiologic information about coronary disease in the United States, the initial components were derived from the Framingham Heart Study; however, whereas Framingham provided....
