How we wish to be cited:
Norberg B. Gender inequality - hereditary vascular
risk [health]. Rondel 2003; 17. URL: http://www.rondellen.net
Gender inequality - hereditary vascular risk
The pedigree of a family, where eight men out of nine had heart infarction before 50 in the first four generations (1). The first event in the fifth generation hit a 20-year-old woman (V:2), the case of whom is reported.
Introduction
There is a conspicuous hereditary pattern of vascular disease in some families (cf 1). However, the nature of this heirloom is obscure. In such a pedigree, during four generations eight men out of nine had their first heart infarction before the age of 50 (Fig 1). No woman was affected in the first four generations.
Now the first event has occurred in the fifth generation (Fig 1); the victim of this event is a young woman (V:2). The aim of the present paper is to describe the case and modify the conclusions by previous researchers of this family.
Case
The patient was a 20-year-old woman with a higher school certificate at 18, length 164 cm, weight about 70 kg. She was married, used contraceptive pills, smoked 3 cigarettes daily, was moderate in physical exercise and drinking habits. She earned her living as a hotel chambermaid while making up her mind about future professional training. No previous illnesses are known at present.
The patient (V:2 in Fig 1) developed a left side hemiparesis due to a cerebral infarction caused by an intima dissection of the right carotid artery at the base of her skull. Her stroke was preceded by a minor trauma to head and neck a few days before, the role of which is obscure. Now, 15 months later, her state has improved, but she is still sick-listed, in active rehabilitation, and in psychological crisis. She has still not regained full control over left leg and left hand. Her marriage has persisted so far. She is expected to return to studies or work within 6-12 months.
Discussion
The misfortune of the present patient suggests that the vascular risks of her family are not confined to overactive athletic manual workers of male gender, living and working i dirty occupations (cf 1). The event also highlights the role of the vessel wall in vascular risk, in addition to blood factors such as lipids, clotting factors, fibrinolysis factors, glucose, and homocysteine. Furthermore, the present event underlines the fact that vascular risk is not restricted to heart.
Women are thought to be less harassed by vascular disease than men. Nevertheless, the present case is compatible with the hypothesis that genetic factors provide an over-riding frame for vascular risk (cf 1); within this frame, risk is modified by class, sex, and soul (psyche). Further investigations with modern methods of molecular biology are desirable in order to verify or falsify this hypothesis. Such projects are in progress in our department, in broad cooperation with other groups within our university (cf 1).
Bo Norberg, MD, Associate Professor
Department of Internal Medicine
University Hospital of Northern Sweden
SE-901 85 Umeå, Sweden.
bo.norberg@vll.se
Phone ++46 90 7850000
Reference
Published November 3, 2003