Women are more likely than men to die from aortic dissection,a tear in the inner wall of the aorta, according to one of the first studies of its kind reported in today’s rapid access issue of
Circulation: Journal of the American Heart Association.
“While women are less likely than men to suffer from a life-threatening tear in the aortic wall, they are more likely to die from it. Female patients with aortic dissection deserve special attention focused on strategies to improve early diagnosis, management and outcomes,” said Christoph Nienaber, M.D., head of the Division of Cardiology at the University Hospital Rostock, Rostock School of Medicine in Germany.
Researchers say 2,000 new cases per year of aortic dissection are reported in the United States and 3,000 annually in Europe.
The major difference in death rates between men and women was in people 66 to 75 years-old.
In one of the first studies to examine gender differences related to aortic dissection, researchers found that women have:
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Different symptoms of acute aortic dissection.
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Less and different pain at the onset than men, which may delay their treatment.
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More in-hospital complications, which may contribute to the higher death rate.
“New ‘female classic’ symptoms have to be defined. If ‘not-so-typical’ female symptoms are taken seriously by both the affected women and the medical community, female patients will hopefully have better outcomes,” said Nienaber, co-founder of the International Registry of Aortic Dissection (IRAD).
This study evaluated 1,078 acute aortic dissection patients (732 men and 346 women IRAD) to determine differences in symptoms, treatment and death rates. Participants were an average 62 years old. Researchers studied two types of aortic dysfunction: acute type A dissection, a tear in the aorta above the heart, and acute type B, a tear in the aorta below the heart. Caucasians comprised 87 percent of the patients.
The women in the registry with aortic dissection were older than the men. More than a quarter (28.6 percent) of the men were 70 years old or more, while almost half (49.7 percent) of the women were. The ratio of type A versus type B dissection was roughly 2:1 in both genders, with 61 percent type A dissection in men and 65.9 percent type A dissection in women. And while a history of hypertension was more frequent in women, prior cardiac surgery was more prevalent among men.