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Update in Women's Health
- Pamela Charney, MD;
- Judith M.E. Walsh, MD, MPH; and
- Ann B. Nattinger, MD, MPH
- 1998-99 Series; John Roberts, MD, Editor From Albert Einstein Medical Center, Bronx, New York; University of California at San Francisco, San Francisco, California; and Medical College of Wisconsin, Milwaukee, Wisconsin. Requests for Reprints: Pamela Charney, MD, Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, Bronx, NY 10461; e-mail, charney@aecom.yu.edu. Current Author Addresses: Dr. Charncy: Department of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, Bronx, NY 10461.
Advances in women's health in 1997 focused on important risk factors for coronary artery disease in women. Information also became available on hormone replacement therapy, especially its risks, its benefits, alternative treatments for it, and why women choose to take it or not take it. Finally, the effectiveness and cost of testing for breast and endometrial cancer received attention.
Coronary Artery Disease
Women develop heart disease about 10 years later than men do, but in women this disease is, as it is for men, the number-one cause of death. Smoking is clearly a major risk factor for heart disease in both sexes, and most physicians already devote substantial attention to smoking cessation counseling. In 1997, studies focused on three other risk factors for heart disease in women: diabetes, hypertension, and hypercholesterolemia.
Women with Diabetes Had Lower High-Density Lipoprotein Cholesterol Levels
U.K. Prospective Diabetes Study 27: plasma lipids and lipoproteins at diagnosis of NIDDM by age and sex. Diabetes Care. 1997; 20:1683-7.
Diabetes is a well-known risk factor for the development of coronary artery disease. However, women with diabetes who have a myocardial infarction are more likely to die than are diabetic men who have the same event [1]. It has been suggested that this higher mortality rate may be partially due to differences between the sexes in lipid profiles.
In this cross-sectional study, the lipid profiles of 2139 men and 1574 women with newly diagnosed type 2 diabetes were compared across age groups and between the sexes; patients ranged in age from 25 to 65 years and were otherwise in good health. These patients were also compared with a group of British persons who did not have diabetes and with participants in the U.S. Lipid Research Clinics Population Prevalence Study.
Only 5% of the women were taking estrogen replacement or oral contraceptives. The women were more obese than the men and …
