A female pattern of ischemic heart disease--a new look at an old problem.

Diseases of the circulatory system are the most common cause of death among women. It should be emphasized that this problem is still underestimated in daily practice. As women are less likely to have significant stenosis in coronary angiography than men, they are regarded to be at smaller risk. At the same time, numerous studies prove that the prognosis of women with ischemic heart disease is serious. Therefore, some researchers suggest distinguishing the so-called "female pattern" of ischemic heart disease, characterized by persistent, often atypical chest pain, positive results for noninvasive tests evaluating ischemia and no significant changes in coronary angiography. It is relevant in the diagnosis of women to assess the global risk, taking into consideration such parameters as inflammation indicators, endothelial dysfunction and microvascular reactivity. There is still no data on optimal treatment, but there seems to be a clear benefit from intensive modification and elimination of risk factors, as well as typical pharmacotherapy with angiotensin-converting enzyme inhibitors, beta-blockers and statins.