Who Is At Risk for Coronary Microvascular Disease?

Women at high risk for coronary microvascular disease (MVD) often have multiple risk factors for atherosclerosis. (See "What Causes Coronary Microvascular Disease?" for a detailed list of these risk factors.)

Women may be at risk for coronary MVD if they have low levels of estrogen at any point in their adult lives. (This refers to the estrogen that the ovaries produce, not the estrogen used in hormone replacement therapy.)

• After menopause, women tend to have more of the traditional risk factors for atherosclerosis, putting them at higher risk for coronary MVD.
• Lower than normal estrogen levels in women before menopause also can put younger women at higher risk for coronary MVD. One cause of low estrogen levels in younger women is mental stress. Another is a problem with the function of the ovaries.

Women who have high blood pressure before menopause, especially high systolic blood pressure, are at higher risk for coronary MVD. (Systolic blood pressure is the top or first number of a blood pressure measurement).

Women with heart disease have an increased risk for a worse outcome, such as a heart attack, if they also have anemia. Anemia is thought to slow the growth of cells needed to repair damaged blood vessels.