UF Researchers Report Pilot Data From National Study Of Women With Heart Disease

March 31, 1998

ATLANTA---To the list of what makes men and women different, add a few new items in the category of heart disease.

Researchers have only recently begun to debate the effects of gender, age, hormones and other factors on the affliction. Now, preliminary findings from a major national study of women with heart disease shed new light, including information on a promising new diagnostic tool for the half of the population that - despite popular perceptions -- has a death rate 10 times that of men.

"Part of the problem has to do with the perception of risk in the female population. For many years it was not really recognized that coronary disease was a major cause of morbidity and mortality in women," said Dr. Jannet Lewis, an associate professor of medicine at the University of Florida College of Medicine.

The first details to be reported from the WISE study - for "women's ischemic syndrome evaluation," are unveiling new insights, though many mysteries remain. The National Institutes of Health is funding the $7 million effort. UF has been granted $1.45 million to conduct its portion of the study.

Among the pilot data reported today (3/31) by researchers from the University of Florida and other WISE investigators: UF cardiologists have spent the past year testing new diagnostic procedures as part of the effort to better identify and treat women with known or suspected ischemic heart disease, caused by blocked or diseased arteries, said Dr. Carl Pepine, co-director of cardiovascular medicine at UF's College of Medicine and principal investigator for UF's portion of the study. Lewis is co-principal investigator.

The condition is noted for an insufficient blood supply to the heart, typically due to obstruction of coronary arteries and blood vessels by fatty cholesterol deposits or disease. It can lead to sudden death or heart attack and causes the chest pain known as angina.

The exact prevalence of ischemic heart disease is unknown, though the American Heart Association estimates it accounts for at least 365,000 deaths annually among women.

To date, UF researchers have enrolled 136 patients, ages 21 to 75, who have ischemic heart disease or who suspect they suffer from it because of chest pain or other related symptoms. About 1,000 women will be tracked nationally for four years at UF and three other sites: the University of Alabama at Birmingham, the University of Pittsburgh and Pittsburgh's Allegheny University of the Health Sciences.

While some techniques will be conducted at all the centers, each will test its own unique procedures. "I think over the last few years, there has been a re-education of both lay people as well as medical professionals about the impact of coronary disease in women, and also a re-direction toward performing trials to get more information that is gender-based," Lewis said.

Participants undergo detailed evaluation, including a physical exam, psychological and quality-of-life tests, detailed hormonal and estrogen receptor evaluations, tests that examine the heart's response to mental and physical stress, and invasive coronary assessments such as angiography, which lets physicians view blood vessels on X-ray films. Researchers also will conduct a series of tests to determine the adequacy of coronary function.

Other imaging tests are done to identify abnormalities of the coronary arteries that occur before the formation of obstructive lesions such as plaque. The heart's smaller vessels, part of the body's "microcirculation," also will be evaluated using a special technique that senses blood flow.

"The latter two techniques should be particularly useful for a large group of women who have severe, recurrent chest pain but no severe coronary narrowings," Pepine said. "Many times these women remain disabled by their symptoms but nobody knows how to treat them, let alone diagnose their condition."

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University of Florida

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