Iowa See article on page 1393. New therapies, new diagnostic tools and even new diseases threaten to overwhelm busy family physicians. Keeping up is hard work. Conscientious physicians appreciate that the incidence and prevalence of certain diseases vary with gender. They are also aware that some conditions have widely different presentations, respond to different therapies or have different effects and outcomes in women compared with men.
Cardiovascular disease is one area in which there are significant differences between the sexes.
As Bedinghaus and associates 1 outline in this issue of American Family Physician , the presentation of cardiovascular disease is surely gender based. Compared with men, women less often have classic anginal symptoms. These symptoms are more likely to be misinterpreted or even discounted by women and their physicians. Atypical presentation is one reason that the diagnosis of cardiovascular disease is often delayed and the initial outcome is poorer in women. 3 Clinical trials investigating primary and secondary prevention of cardiovascular disease have inadvertently or even systematically excluded women from participation.