Where men and women do differ is in the age at which they tend to show up in their doctors' offices with symptoms of CVD. Whereas men typically begin appearing with symptoms of CVD in their fifties, women generally don't begin showing similar symptoms until their sixties.
Women seem to be somewhat protected from CVD by estrogen, one of the hormones essential to reproduction. Estrogen acts as a vasodilator; that is, it tends to relax blood vessels, opening them up. Thus, even when decades of poor health habits have led to a build-up of plaque in a woman's coronary arteries, thanks to estrogen, the arteries are more likely to remain open, reducing the risk of blockages that shut off blood flow to the heart and cause chest pain or heart attack. Estrogen may also have some beneficial effects on blood cholesterol levels.
Until menopause, that is. Once a woman reaches menopause and her estrogen levels begin to fall, she also begins to lose the protective effects of the hormone. Very quickly, her risk of heart attack and other cardiovascular diseases rises sharply to equal that of men. Because women tend to be older than men when the first symptoms of CVD appear, the disease is also often complicated by other health problems such as diabetes, making effective treatment more difficult. Thus the mortality rate from CVD among women very quickly catches up with that for men.
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