Why do women live longer than men do?

Potential Reasons for Gender Differences in Mortality

Females are more hardy

Males engage in riskier behaviors (factor after birth and infancy)

Men engage in riskier sports

Males tend to hold high stress or higher risk jobs

Men tend to have poorer health habits (e.g., drink more alcohol)

Social support may be more protective in women

 

More fit – more males are conceived but more female fetuses are born.  This trend persist in infancy so that more male babies are likely to die.  Thus, females may be more hardy. Essentially, no one really knows why there is the female advantage. Conflicting reports on social support since marriage appears to benefit men more than women. All of these factors may operate to increase the mortality rates in men.

Risks Factors

Family history

Marital status (adds 10 yrs in men; 4 yrs in women)

Economic status

Body weight

Exercise

Alcohol (add 2 years if drink 1-3 drinks/day)

Smoking

Disposition (add 2 yrs if reasoned, practical)

Education

Environment (add 4 yrs if rural)

Sleep (more than 9 hours subtract 5 years)

Temperature (add 2 yrs if thermostat is < 68)

Health care – regular check ups add 3 yrs

Three Themes of Adaptation

Find meaning: why illness happened or rethink priorities

Gain sense of control, control symptoms and treatment

Restore self-esteem, Often by comparison with worse off others

Heart Disease, Symptoms of a heart attack, Who Is At Risk of Heart Disease?

Due to narrowing or blocking of the coronary arteries is the main cause of heart disease.

Angina pectoris: Painful cramp in chest, arm, neck, or back due to brief blockage of oxygenated blood to the heart. More often during exercise, stress, cold temperature, digesting large fat meal are the reason, little or no permanent damage. 

Myocardium: Muscle tissue around the heart

Myocardium infarction (heart attack): Prolonged blockage of blood to an area of the heart resulting in muscle tissue damage is the reason of myocardium infarction (heart attack).

Symptoms of a heart attack

Pressure in chest, fullness, squeezing pain.

Pain spreading to shoulders, neck, or arms.

 Lightheadedness, fainting, sweating, nausea.

Who Is At Risk of Heart Disease?

Prevalence increases with age, particularly after 45 years of age. Prior to 50s, 60s, men are at greater risk than women but increases in women after menopause. More women than men are likely to die from a heart attack. Blacks are at higher risk, Asians are at lower risk.

Heart Disease Risk Factors

High blood pressure

Family history

Cigarette smoking

High LDL and total cholesterol levels

Physical inactivity

Diabetes

Obesity

Stress

Why high blood pressure a risk factor?

Heart has to work harder. Since heart muscle is working harder, it can become enlarged. Wear and tear on the arterial wall can increase the likelihood of lipid and calcium deposits adhering to the arterial wall.  This leads to hardening of the arteries.

Physiological Reactivity, Medical Treatment & Rehabilitation

Physiological Reactivity

Physiological and cardiovascular reactivity to acute stress (“hot reactors”). Exaggerated increases in blood pressure, heart rate, catecholamines, corticosteroids. High levels of these hormones can damage heart and blood vessels. Presence of epinephrine (a catecholamine) increases the formation of clots.

Medical Treatment

Initial treatment may involve clot-dissolving medication and close monitoring

Balloon angioplasty, tiny balloon is inserted into blocked vessel and inflated to open blood vessel

Bypass surgery, Use grafted vessel (e.g., piece from leg) to bypass blockage in artery to the heart

Medications (e.g., beta blockers, calcium channel blockers) to protect heart and improve function.

Risk management is control of high blood pressure and control of lipid abnormalities.

Rehabilitation

Promote recovery and reduce risk of another attack

Heart disease is chronic condition requiring ongoing management.

Exercise is Physiological and psychological benefits

Weight management

Smoking cessation

Lipid and BP management include dietary changes to control lipids

Reduce excessive alcohol intake

Stress management

What is a stroke? Symptoms of a Stroke and Causes of Strokes

What is a stroke?

Tissue damage to area of the brain due to disruption in blood supply, depriving that area of the brain of oxygen.

Symptoms of a Stroke

Weakness or numbness of the face, arm, or leg (usually on one side of the body)

Dimness or loss of vision (usually one eye)

Loss of speech or trouble talking or understanding speech

Unexplained, severe headache

Dizziness, unsteadiness, or sudden fall

Causes of Strokes

1. Infarction – blockage in cerebral artery that cuts off or reduces blood supply

a)      Thrombosis – blood clot

b)      Embolus – piece of plaque becomes lodged in the artery. 

2. Hemorrhage – happens suddenly.  Less frequent than infarction but more damaging and more likely to cause death.

Stroke Risk Factors, Effects of a Stroke

Stroke Risk Factors

Rare up to age 55, than risk increases sharply with age (doubling with each decade). More common in men but women more likely to die from them. Rates highest among blacks and lowest among Asians. Family history, high blood pressure, cigarette smoking, heart disease, diabetes, and their risk factors such as obesity and physical inactivity. High red blood cell count (making the blood thicker and likelier to clot). Mini-strokes – transient ischemic attacks (TIA) TIAs may occur one or more times before a stroke.

Effects of a Stroke

Some motor, sensory, cognitive, or speech impairment usually occurs. Limitations may be permanent but lessen in severity over time. Younger patients recover better than older. Impairments caused by hemorrhages more easily overcome than those caused by infarctions. Motor impairments often due to paralysis on one side of the body (side opposite to brain damage). After about 6 weeks of rehab about 50% of patients can perform independently (many with cane or walker). Language, learning, memory, and perception problems depend on location of the injury.  Left-hemisphere damage more commonly associated with language problems called aphasia. Receptive aphasia – difficulty understanding verbal information. Expressive aphasia – difficulty producing and using language. Damage to right side of brain often associated with difficulties in visual processing and emotions. The difficulty with emotions can be either managing their own emotions or understanding those of others.