Since 1984, more women than men have died each year from heart disease

Denise Grady:

Kim Kachmann-Geltz did everything right. She ran five miles a day, ate wheat toast and oatmeal, stayed slim, never smoked. Her blood pressure was perfect. Her genes, she thought, were good: Her great-grandmother had lived to 102.

"I'm the last person in the world I could ever imagine having heart disease," said Kachmann-Geltz of Hilton Head, S.C., who is 39 and the mother of three children. But since 2003 she has suffered from angina, chest pain caused by poor blood flow to the heart. One chamber of her heart has shown signs of enlargement, and her heart valves do not work properly.

She takes four heart drugs, but chest pain keeps her from running. She walks instead and does yoga.

Her case is unusual: Angina more often strikes older women. Still, coronary artery disease is the leading cause of death in women over 25, killing more than 250,000 a year in the United States. Before they reach their 60s, women are less likely than men to develop heart problems, but once the disease does occur, women often fare worse.

Since 1984, more women than men have died each year from heart disease. Though overall coronary death rates have dropped in recent decades, most of the improvement has been in men.

Puzzling differences have emerged between men and women with heart disease, making it plain that past studies, mostly on men, do not always apply to women. Researchers have come to realize that to improve diagnosis and treatment for women, they must sort out the differences.

"Every time we turn around, we find more gender differences, so it's important to study," said Dr. C. Noel Bairey Merz, a cardiologist at Cedars-Sinai Medical Center in Los Angeles.

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