Studies have shown that women are more likely than men to have coronary microvascular disease (MVD). Women at high risk for the disease often have multiple risk factors for atherosclerosis. (For a detailed list of these risk factors, go to "What Causes Coronary Microvascular Disease?")
Women may be at risk for coronary MVD if they have lower than normal levels of estrogen at any point in their adult lives. (This refers to the estrogen that the ovaries produce, not the estrogen used in hormone therapy.)
Low estrogen levels before menopause can raise younger women's risk for coronary MVD. One cause of low estrogen levels in younger women is mental stress. Another cause is a problem with the function of the ovaries.
Women who have high blood pressure before menopause, especially high systolic blood pressure, are at increased risk for coronary MVD. (Systolic blood pressure is the top or first number of a blood pressure measurement.)
After menopause, women tend to have more of the traditional risk factors for atherosclerosis, which also puts them at higher risk for coronary MVD.
Women who have heart disease are more likely to have a worse outcome, such as a heart attack, if they also have anemia. Anemia is thought to slow the growth of cells needed to repair damaged blood vessels.
Celebrating American Heart Month: NIH Advancing Heart Research10/14/2014