A study published in PLOS ONE reported a high incidence of atherosclerosis among middle-aged women, even if it does not reveal any symptoms. Researchers assessed traditional risk factors for atherosclerosis to see if they can help detect and prevent heart disease.

Atherosclerosis is a health condition where the build-up of plaque inside the arteries impedes the body’s ability to deliver oxygenated blood throughout the body. The build-up of plaque is thought to begin as early as in childhood, with genetics and lifestyle choices (diet, smoking, obesity, physical inactivity, stress) affecting the rate of their continued growth.

Common symptoms of atherosclerosis include angina, high blood pressure, and peripheral vascular disease although most individuals are asymptomatic until mid-life. If the plaques get too big, they can also block the blood flow causing a heart attack or a stroke.

Data from a study published by Pfizer asserts that atherosclerosis in its various forms causes one in five deaths in Canada. Furthermore, there is evidence that, since women tend to be diagnosed 10 to 15 years later than men, their rate of death following a heart attack is nearly twice as high compared to men.

Since early diagnosis and treatment of atherosclerosis improves health outcomes, researchers from Brazil investigated if there was a way to better identify subclinical atherosclerosis in middle-aged women. Their study, published in PLOS ONE, was based upon data collected from 823 women (ages 45-65 years) from October of 2009 to October of 2011.

They found that, despite being without symptoms, atherosclerosis was common among these women. The prevalence of atherosclerosis was 12.7% for the entire study population and 11% for the very low-risk population. In addition, common predictors of atherosclerosis such as smoking, obesity, high blood pressure, and high cholesterol levels were also predictive of participant’s degree of plaque build-up.

One limitation of this study is that the sample was drawn from health centres which serve low-income communities. Nonetheless, one important takeaway is that due to the likelihood of asymptomatic atherosclerosis in women, even those seen as low-risk for heart disease, all middle-aged women should receive education on cardiovascular disease as well as access to prevention programs.

Written by Debra A. Kellen, PhD


(1) de Barros, I. L., Costa, L., Bezerra, B., Gomes, R., Morais, N., Strunz, C. M., … & Nicolau, J. C. (2018). Predictors of subclinical carotid atherosclerosis in middle-aged women. PloS one13(5), e0197582.
(2) Jones, D. J., Bromberger, J. T., Sutton-Tyrrell, K., & Matthews, K. A. (2003). Lifetime history of depression and carotid atherosclerosis in middle-aged women. Archives of General Psychiatry60(2), 153-160.

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