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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EGender-specific differences in cardiovascular medical treatment are not entirely unexpected, due to gender differences in physiology and pharmacodynamics, symptomology, treatment response, and representation in clinical trials.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EHypertensive Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHeart Failure\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ELipid Disorders\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EGender-specific differences in cardiovascular (CV) medical treatment are not entirely unexpected, due to gender differences in physiology and pharmacodynamics, symptomology, treatment response, and representation in clinical trials. Ernst Van der Wall, MD, PhD, Leiden University Medical Center, Leiden, the Netherlands, discussed these differences.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003ECardiovascular disease (CVD) is the primary cause of death among women, killing 8.6 million women worldwide every year. Yet, a significant gender gap exists in treatments that are offered to women compared with men. For example, the time from symptom onset to hospital presentation for myocardial infarction (MI) is greater in women (3.46% longer time to presentation; 95% CI, 1.06 to 5.92; p=0.005), despite national campaigns that are aimed at increasing women\u0027s awareness of their risk of heart disease [Dierks DB et al. \u003Cem\u003EAm Heart J\u003C\/em\u003E 2010].\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EHistorically, randomized clinical trials have included a majority of men, although this has changed over time. A systematic review of treatment of mild to moderate hypertension [Ljungman C et al. J \u003Cem\u003EWomens Health\u003C\/em\u003E 2009] showed an increase in the proportion of women with hypertension (r=0.27; p\u0026lt;0.05). Another study found that all treatments that were studied provided broadly similar protection against major CV events in men and women (p-homogeneity \u0026gt;0.08) [Turnbull F et al. \u003Cem\u003EEur Heart J\u003C\/em\u003E 2008].\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EA meta-analysis on statin therapy in the two sexes found that statin therapy reduced the risk of coronary heart disease events in men without prior CVD but not in women. No differences between the genders were found regarding total mortality [Petretta M et al. \u003Cem\u003EInt J Cardiol\u003C\/em\u003E 2010]. Another study showed that women might be less responsive to aspirin than men in preventing nonfatal MI. Trials predominantly with female subjects indicated a much lower risk reduction than those that were made up mostly of men (RR, 0.87 [95% CI, 0.71 to 1.06] vs RR, 0.62 [95% CI; 0.54 to 0.71]) [Yerman T et al. \u003Cem\u003EBMC Med\u003C\/em\u003E 2007].\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EEvidence-based guidelines for CVD prevention in women have been revised on the basis of more definitive data about menopause, aspirin, and folic acid therapies. Class III interventions that are not useful\/effective and may be harmful for CVD or MI prevention in women have been specified. Hormone therapy and selective estrogen receptor modulators, antioxidant vitamin supplements (vitamins E, C, and beta-carotene), and folic acid should not be used for primary or secondary prevention of CVD [Mosca L et al. \u003Cem\u003ECirculation\u003C\/em\u003E 2007].\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EProf. van der Wall pointed out that there may be differences in the underlying causes of and outcomes that are related to heart failure in women compared with men. For example, women who are admitted to the hospital with heart failure have better 1-year survival rates than their male peers (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E) [Mejhert M et al. \u003Cem\u003EEur J Heart Failure\u003C\/em\u003E 1999]. In addition, testosterone treatment may not benefit men with heart failure but may benefit women [van der Wall EE. \u003Cem\u003ENeth Heart J\u003C\/em\u003E 2011]. Of note, 30-day mortality after PCI in men and women has decreased in the past 25 years, with no differences in short- or long-term mortality between men and women [Prasad A et al. \u003Cem\u003EJACC\u003C\/em\u003E 2008].\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/10\/35\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Survival Rates with Respect to Gender in Patients Admitted with Heart Failure 1 Year After Hospital Discharge.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1761151424\u0022 data-figure-caption=\u0022Survival Rates with Respect to Gender in Patients Admitted with Heart Failure 1 Year After Hospital Discharge.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/10\/35\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/10\/35\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/10\/35\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/12460\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-8\u0022 class=\u0022first-child\u0022\u003ESurvival Rates with Respect to Gender in Patients Admitted with Heart Failure 1 Year After Hospital Discharge.\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EReproduced with permission from Oxford University Press. Diagnostic tests, treatment and follow-up in heart failure patients \u2014 is there a gender bias in the coherence to guidelines? Mejhert M et al. \u003Cem\u003EEur J Heart Fail.\u003C\/em\u003E Dec 17, 1999.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-9\u0022\u003EMany women are unaware of specific risk factors and assume they are less likely to suffer from stroke, heart failure, or heart attack. But, this assumption is incorrect. Prof. van der Wall noted that prescribing physicians should be aware of gender-specific treatments, that all guidelines should account for gender-specific differences, and that such guidelines should be implemented accordingly.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2011 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/11\/10\/35.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzmz8d\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmz8d\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}