Coronary heart disease: is gender important?

Small Dense Low Density Lipoprotein Cholesterol, Paraoxonase 1 and Lipid Profile in Postmenopausal Women: Quality or Quantity?

BACKGROUND AND AIMS

Atherosclerosis, the root cause of cardiovascular disease (CVD), has a number of risk factors-some modifiable and some not. CVD increases in women particularly during the postmenopausal period. Small dense low-density lipoprotein (sdLDL), a subclass of LDL, is an important determinant of atherosclerosis in postmenopausal women. Paraoxonase1 (PON1) is a high-density lipoprotein (HDL)-associated enzyme that prevents oxidative modifications in LDL and HDL. With this background, we studied the sdLDL-C, PON1 and lipid profile in postmenopausal women to compare between quality and quantity of LDL.

METHODS

We studied 80 pre- and postmenopausal women (40/group). The following parameters were studied: lipid profile, sdLDL-C and PON1 levels. With proper statistical tools the correlation between these parameters was studied.

RESULTS

Postmenopausal women, in comparison with premenopausal women, have significantly increased levels of serum triglycerides and sdLDL-C and very-low-density lipoprotein cholesterol (VLDL-C) and significantly decreased levels of HDL-C and PON1. PON1 activity was negatively correlated with age, TC, TG, LDL-C and sdLDL-C (r = -0.574, -0.119, -0.226, -0.473 and -0.455, respectively) and positively correlated with HDL-C (r = 0.368), whereas sdLDL-C was positively correlated with age, TC, TG, LDL-C (r = 0.633, 0.485, 0.561 and 0.705, respectively) and negatively with HDL-C (r = -0.235). Stepwise multiple regression analysis demonstrated HDL-C and menopausal status as the best determinant for PON1 (R(2) = 0.320, p < 0.05) and menopausal status, LDL-C, TG, and TC were the best determinants for sdLDL-C (R(2) = 0.606, p < 0.05).

CONCLUSION

The results of the present study suggest quality, i.e., sdLDL-C, is more important than only LDL-C levels. Similarly, decrease in PON1 and increase in sdLDL-C go hand in hand. This shows that antioxidant capacity is compromised with a qualitative downfall in lipoproteins in postmenopausal women.

The Relationship Between Social Support and Adherence to Healthy Lifestyle Among Patients With Coronary Artery Disease in the North of Jordan

Numerous studies have shown that social support improves health behaviors in patients with coronary artery disease (CAD). The purpose of this study was to examine the relationship between adherence to a healthy lifestyle, and social support and selected sociodemographics among patients with CAD. Cross-sectional descriptive design was used. A convenient sample of 153 patients with CAD was recruited from the cardiac clinic in an educational hospital in the north of Jordan. One hundred and thirty-three patients completed the interview. Social support was the most significant predictor— t(124) = 9.51, p < .001—which explained 60% of variance in adherence to a healthy lifestyle. Providing patients with adequate social support improves adherence to a healthy lifestyle. More attention should be given to the elderly and patients with low income to enhance adherence to a healthy lifestyle. The applications of this study in practice provide a guide for nursing clinical assessment of social support for patients facing CAD.

Constructing the 'gender-specific body': A critical discourse analysis of publications in the field of gender-specific medicine

Gender-specific medicine, a new and increasingly influential ethos within medical research and practice, has received little critical attention to date. The objective of this article is to critically examine the attributes of gender-specific medicine as imparted by its advocates. Through a critical discourse analysis of its two leading academic journals, we identify five interrelated discourses: of male/female difference; of hegemonic biology; of men's disadvantages; of biological and social reductionism; and of the fragmented body. Together these comprise a master discourse of the 'gender-specific body'. The discourse of the 'gender-specific body' is discussed in relation to the current neoliberal political agenda which frames healthcare as a market good and locates health and illness in individual bodies rather than in the wider social arrangements of society. We argue that the 'gender-specific body' threatens not only to turn back the clock to a vision of the biological body as fixed and determinate, but to extend this ever deeper into the social imagination. Lost in the process is any meaningful sense of the human body as a relatively open system which develops in interaction with its social world. We propose that, as it gains momentum, the 'gender-specific body' is likely progressively to circumscribe our thinking about the health of women and men in potentially problematic ways.

Are men shortchanged on health? Perspective on life expectancy, morbidity, and mortality in men and women in the United States

BACKGROUND

Significant gender disparities exist in life expectancy and major disease morbidity. There is an urgent need to understand the major issues related to men's health that contributes to these significant disparities. It is hypothesized that men have higher and earlier morbidities, in addition to behavioral factors that contribute to their lower life expectancy.

METHODS

Data was collected from CDC: Health United States, 2007; American Heart Association, American Obesity Association, and American Cancer Society.

RESULTS

Men have lower life expectancy than women in most countries around the world including United States. This gender disparity is consistent regardless of geography, race and ethnicity. More men die of 12 out of the 15 leading causes of death than women. In addition, men have higher morbidity and mortality in coronary heart disease (CHD), hypertension, diabetes, and cancer.

CONCLUSIONS

Men's lower life expectancy may be explained by biological and clinical factors such as the higher incidence of cardiovascular metabolic disease and cancer. In the context of public health, raising awareness of cardiovascular and metabolic health is needed to reduce the gender disparity. In addition, consideration of preventive and early detection/intervention programs may improve men's health.

Nutritional Differences between Elderly Men and Women

BACKGROUND

Many differences exist between the two genders, i.e., biological, sociological, and also behavioral, which often depend on age.

OBJECTIVES

The aim of this study was to find characteristic differences between nutritional habits of elderly men and women.

METHODS

266 elderly people (109 men >65 years, and 157 women >60 years) were consecutively selected from primary care patients, in Budapest, Hungary. A self-managed questionnaire was filled in on lifestyle and eating habits, including a food frequency questionnaire. Medical check-up, registration of anthropometrical parameters, and laboratory tests were also performed. 53 subjects were also involved in a 3-day dietary recall.

RESULTS

The meal frequency was increased during aging in both genders, especially in men. Lunch was preferred by most of the women as a principal meal, but one quarter of the men had a filling dinner instead of lunch. Alcoholic beverages were consumed more and frequently by men. The fluid intake was low, especially in women. Milk and diary products, fresh fruit, bread, biscuits, chocolate, coffee and vitamin supplements were consumed more frequently by women. Almost all types of meat, eggs, and vegetables were more preferred by men and their energy intake was also higher (9.75 vs. 8.78 MJ). In both genders, fat represented a higher ratio (39%) of energy intake than recommended. The increase of body weight from youth to elderly was greater in women (14.04 vs. 10.65 kg). Prices had a higher impact on food purchases by women.

CONCLUSION

High energy intake over decades led to overweight in both genders (BMI >27 kg/m(2)). It seemed that the eating habits and food choices of women were closer to healthy ones and recent recommendations, although due to metabolic reasons and to the lower energy expenditure, they gained more weight. The elderly are the target population on every level of medical care. Further evaluations are needed to determine the differences in nutrition and to promote better administration of drugs and to establish public health suggestions.