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DIRECTIONS: Choose the one best response to each question

In the United States, which of the following is the most common cause of death?

A. Accidents and trauma

B. Cancer

C. Cardiovascular diseases

D. Chronic kidney disease

E. Dementia

The answer is C. (Chap. 231) While age-adjusted death rates for coronary heart disease have declined by two-thirds in the last four decades in the United States, cardiovascular diseases remain the most common causes of death, responsible for 35% of all deaths, almost 1 million deaths each year. Approximately one-fourth of these deaths are sudden. In addition, cardiovascular diseases are highly prevalent, diagnosed in 80 million adults, or ~35% of the adult population. The growing prevalence of obesity, type 2 diabetes mellitus, and metabolic syndrome threatens to reverse the progress that has been made in the age-adjusted reduction in the mortality rate of coronary heart disease.

Regarding the associations of gender and cardiovascular disease, which of the following statements is true?

A. Cardiovascular disease accounts for a higher percentage of deaths among men versus women.

B. Exercise electrocardiography has a higher diagnostic accuracy in women than in men for the prediction of epicardial obstructive coronary disease.

C. Obesity and the metabolic syndrome play a less prominent role in the development of coronary atherosclerosis in women than in men.

D. The absolute number of deaths attributable to cardiovascular disease has risen in women over the past several decades.

E. None of the above are true.

The answer is D. (Chap. 231) For years, cardiovascular disease was thought to be more common in men than in women. However, while the absolute number of deaths secondary to cardiovascular disease has declined over the past decades in men, this number has actually risen in women. In fact, the percentage of all deaths secondary to cardiovascular disease is higher among women (43%) than among men (37%) In addition, Inflammation, obesity, type 2 diabetes mellitus, and the metabolic syndrome appear to play more prominent roles in the development of coronary atherosclerosis in women than in men. Coronary artery disease is more frequently associated with dysfunction of the coronary microcirculation in women than in men. Exercise electrocardiography has a lower diagnostic accuracy in the prediction of epicardial obstruction in women than in men.

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