Watching out for women

Dr. C. Noel Bairey Merz is making a difference for women everywhere.

An internationally renowned cardiologist, Bairey Merz and her team are changing how doctors view women and heart disease.

For many women, plaque buildup starts in the small arteries, and it's not being diagnosed using conventional methods. It's possible that up to 3 million women in the U.S. have microvascular heart disease, said Bairey Merz, chairwoman of a government-sponsored study of the disorder, called Women's Ischemia Syndrome Evaluation. It's not getting diagnosed with angiograms, exercise stress tests or electrocardiograms.

Cedars-Sinai Medical Center, where Bairey Merz practices, provides a diagnostic test aimed at this condition. So far, it's the only one on the West Coast.

As scary as that is, it's not unusual that a disease mostly affecting women could be over looked for so long.

"We just didn't study women," she says. "It's a major problem through all of our health-science research. Very little of it looks at balanced groups of men and women and very few studies are just of women."

Even companies that are supposed to be innovating medicines neglect to include women. Bairey Merz says that nine out of 10 drugs withdrawn from the Food and Drug Administration because of unanticipated side effects are side effects that affect women.

The National Institute of Health emphasized studying women when it started to notice, about 20 years ago, that women were dying of diseases at a higher rate than men despite their anticipated longevity.

Other changes in the medical community have been spurred by women.

"A number of investigators are women - finally," Bairey Merz said. "We have a little bit of power now to control what studies are being done and on whom.

"As opposed to being the victims, we are starting to get some control."

In the case of microvascular heart disease, gender differences are becoming apparent. It seems simple, but it has to do with how men and women store fat differently. Men gain weight in the belly while women tend to distribute it right under the skin in various places. Now it appears that women distribute artery plaque differently.

A small amount of plaque buildup in the small arteries causes them to dysfunction, they constrict when they are supposed to dilate, and this appears to predominately be a problem in women. The buildups in the larger arteries, which can be detected in the traditional exercise stress tests and angiograms, seem to affect more men. Why?

Researchers are trying to figure that out.

"Just like we know men and women deposit body fat differently, clearly they are different in other physiological functions. Men have higher testosterone levels than women, so that might have something to do with it."

• Contact reporter Becky Bosshart at bbosshart@nevadaappeal.com or 881-1212.