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Oct 22, 2015

Experts Call for More Research on Microvascular Disease—A ‘Woman’s Problem’

Better diagnosis and treatment are needed for this heart condition that is often overlooked.

Microvascular disease, or non-obstructive heart disease, is a type of heart disease that affects tiny coronary arteries. Unlike traditional heart disease, which occurs when plaque forms in the major arteries, microvascular disease happens when there’s damage to the inner walls of the blood vessels, reducing blood flow to the heart.

Microvascular disease is especially common in women and can cause symptoms like chest pain and shortness of breath. While microvascular disease does not have the same risk of complications as traditional heart disease, it can increase cardiovascular risk. The problem is that our knowledge around the diagnosis and treatment of microvascular disease is limited.

To address this issue, experts recently published a call to action in the Journal of the American College of Cardiology. In this paper, experts reviewed what we know about microvascular disease and urged future research on the topic.

As authors explain, much of what we know about microvascular disease comes from the WISE study (Women’s Ischemia Syndrome Evaluation), funded by the National Heart, Lung and Blood Institute. First started in 1996, the WISE study was designed to increase knowledge about heart disease in women.

Thanks to study findings, we now know that microvascular disease affects roughly 10% of patients with acute coronary syndrome, an umbrella term for conditions that reduce blood flow to the heart. However, women are twice as likely to have microvascular disease than men. Women are also less likely to receive the recommended treatments to reduce symptoms and cardiovascular risk. While death rates from microvascular disease are low, experts explain that they’re not negligible.

As a result, authors encourage additional research about the diagnosis, treatment and prevention of microvascular disease. In general, testing for microvascular disease remains costly, and we need better, more efficient ways to detect this condition. We also need to identify effective treatment options and clarify which treatments are most appropriate for which patients. With future research, authors hope to learn more about microvascular disease and apply findings to improve both outcomes and quality of life.

Read the full article in the Journal of the American College of Cardiology.

Questions for You to Consider

  • What is microvascular disease?
  • Microvascular disease, or non-obstructive heart disease, occurs when the heart’s small blood vessels are damaged, decreasing blood flow to the heart. Women develop non-obstructive heart disease more often than men. Diagnosing this condition can be a challenge, since standard tests are not designed to detect this microvascular disease.

  • What are the signs and symptoms of coronary microvascular disease?
  • The most common signs of coronary microvascular disease (also called nonobstructive coronary heart disease) include chest pain, shortness of breath, sleep problems, fatigue and a lack of energy. Most often, patients experiencing these symptoms first notice them during times of mental stress or during physical activity.


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