Diagnosis and treatment of heart disease: are women different from men?

Key questions concerning strategies for diagnosis, prevention, and treatment of heart disease in women remain unanswered. Thrombolytic therapy has been shown to reduce mortality similarly in men and women. In addition, percutaneous coronary intervention for acute coronary syndromes is as effective in women as in men. However, after hospital discharge, medical treatment carries different benefits in men and women. Aspirin has not been definitively proven to prevent cardiovascular events in women. Men and women respond differently to statins. Men may experience a greater benefit than women from angiotensin-converting enzyme inhibitors. β-Blockers substantially improve survival in women, with possibly a greater benefit than in men. Clopidogrel appears to be equally effective in reducing cardiovascular events in both men and women. Our report will review current knowledge supporting sex differences in the diagnosis and treatment of ischemic heart disease. A clear definition of the state of the science, with recognition of the shortcomings of current data, is necessary to guide future research and move the field forward.