A surprising new study finds that women in their 60s have as many risk factors for heart disease as men, and by their 70s have more, according to research led by demographers at the University of Southern California.

The findings, published in the current issue of the Journal of Women's Health, reflect a change from previous decades when older men were at greater risk for heart disease. Instead this research shows over the last 10 years, older women are doing worse, while men are doing better.

Women's risk for heart disease is still lower than men's through middle age. But the break-even point at which women catch up to men is now at age 60, 10 years earlier than before. "Women are no longer protected from heart disease risk relative to men," said Eileen Crimmins, corresponding author and professor in USC Leonard Davis School of Gerontology. "Reports indicating that men are more likely to have more high-risk levels of blood pressure and cholesterol are no longer true in the U.S. population over 60 years of age."

Crimmins and her colleagues examined changes between 1988 and 2002 in indicators related to cardiovascular disease. The research team used data on men and women 40 and older from two broadly representative samples of the US population, approximately 10 years apart.

Among the findings:

*High risk blood pressure - both diastolic and systolic - increased in women but decreased in men. Medication against hypertension appeared to be more effective in men than women.

* Both men and women saw a decrease in high-risk HDL cholesterol, but men showed greater improvement. The use of cholesterol-lowering medication increased somewhat more for men.

* More women than men had high C-Reactive Protein (a marker of infection that in elevated levels has been shown to be a risk factor for cardiovascular disease). This appears to be associated with increased use of hormone-replacement therapy, Crimmins said.

A New Type of Heart Disease?

Heart disease with arteries that appear to be free of cholesterol-filled bulges isn’t a contradiction in terms. Up to 3 million American women — and some men — may have this “new” form of heart disease.

If a “standard approach” to identifying and diagnosing heart disease exists, it goes something like this: You notice pain or tightness in your chest when climbing stairs or lugging groceries into the house. Your doctor sends you for an exercise stress test. As you walk on the treadmill, the electrocardiogram shows that part of your heart isn’t getting enough oxygenated blood. Next stop: angiography. This special x-ray shows that cholesterol-filled plaque has narrowed one of your coronary arteries by 75% or more. Treatment follows.

This sequence, it turns out, doesn’t work nearly as well in women who have chest pain, shortness of breath, unusual fatigue, or other signs of reduced blood flow to part of the heart as it does in men. Many women don’t have the strength or endurance to complete an exercise stress test. And a whopping half or more of women who have alarming stress tests have what look to be clear coronary arteries on an angiogram.

In the past, such women were told not to worry; this wasn’t really dangerous heart disease. Relatively few were counseled to start the same kinds of therapies as men with he