Guidelines for CVD and women don’t exist

Extant protocols based on men

"No guidelines exist that tell physicians when to look for coronary disease in women," says Judith Monteferrante, MD, a cardiologist at the George E. Reed Heart Center in Hawthorne, NY. "Coronary disease is more defined in men. For example, if a man is sedentary, the guideline mandates exercise. Men over the age of 40 are told to get a stress test. No such parameters exist for women."

There’s a Catch-22 operating here. Exercise stress tests have to be interpreted in a way peculiar to women when they are being diagnosed. Testing is not only less predictive in a woman than in a man because women with CVD tend to be older, but also women have a higher ejection fraction at rest. Nearly one-third don’t increase the parameter with exercise. That factor affects diagnostic exercise testing.

In addition, since guidelines are based on men’s reactions, women’s responses to commonly prescribed cardiac drugs may differ from the male-based "norm."

"Women have a responsibility to preserve their health at an early age," continues Monteferrante. "They have to find physicians who are focused on preventive medicine and who are aware of the importance of a healthy lifestyle beginning at an early age."