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Summary

More women than men die annually from ischaemic heart disease (IHD) in the developed world. This represents a reversal of fortune from previous decades and places women firmly as the new majority now impacted. Notably, the adverse IHD gender gap is the widest in relatively young women, where myocardial infarction (MI) mortality is 2-fold higher in women under 50 years compared with age-matched men. While it is now clear that there are many gender differences in IHD outcomes, including more frequent angina diagnosis, more office visits, more avoidable hospitalisations, higher MI mortality, and higher rates of heart failure in women compared with men, the aetiologies contributing to these differences are less clear.

Content

This article, published by the European Heart Journal, questions whether we have a sufficient fund of knowledge to close the persistent gender gap in IHD and vanquish the Yentl syndrome to history. While increasing knowledge exists regarding pathophysiological mechanistic pathways for ‘female-pattern IHD’, translational studies aimed at developing practical diagnosis and therapeutics with both traditional and novel treatments are needed. Further closure of knowledge gaps related to the paradox and the pathophysiology of IHD in women is one of our highest priorities to improve the health of the 51% of the population that is female and represent currently the majority of deaths.

The Yentl syndrome is alive and well (March 2011) https://academic.oup.com/eurheartj/article/32/11/1313/2398378

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