(dailyRx)
Men and women are just wired differently. And for this reason it makes sense that measures taken to identify and treat heart disease in men might not make sense in women.
Dutch researchers have determined that a CT scan for coronary calcium to determine heart disease risk is worth the cost for men, but not for women. A coronary calcium CT scan allows doctors to determine the amount of plaque build up in blood vessels that lead to the heart.
Bob J.H. van Kempen, the study’s lead researcher from Erasmus Medical Center’s department of epidemiology in the Netherlands, and his colleagues found that the screening tool for patients with a moderate risk of heart disease benefits men, but that women would be better served through lifestyle advice and medications.
Researchers used a computer model to evaluate four different scenarios, then considered the chance patients would have a heart attack or stroke and its impact on costs and risks. The strategies evaluated included general treatment without specific interventions for the heart, treatment with heart-related lifestyle management, CT screening for coronary calcium, and blood pressure and cholesterol medications for all patients.
The computer program then simulated the intermediate risk over a patient’s lifetime in those of varying ages and genders, and determined treatment costs and the cost effectiveness of such treatments.
They found that in men CT scanning for coronary calcium was more effective, but also more expensive than the other three strategies. Investigators calculated that an additional $48,800 would need to be spent for each extra year of quality health in men.
In women, CT screening also was more costly and more effective than other options, but did not appear to be cost effective.
The research was recently published in the Journal of the American College of Cardiology.
Coronary artery disease is the leading cause of death in the United States and in the rest of the world. Estimates point to almost one half of all middle aged men and one third of all middle aged women in the United States developing some form of CAD. The primary symptom of angina, commonly known as chest pain, occurs when the artery is almost completely blocked.
Plaques made up of cholesterol and fibrous tissue lodge in the walls of the arteries that supply blood to the heart. Slow growth of the plaques can cause chest pain as they restrict blood flow to the heart muscle, and complete closure or rupture of the plaque can cause a myocardial infarction, commonly known as a heart attack, with resulting disability or death. CAD is primarily a disease of diet and habits, with the greatest risk factors coming from smoking, high blood pressure, high cholesterol, and diabetes.