H&S 8-9

9/2003

Abstract
Women and Coronary Artery Disease (CAD).

Prepared by:    Youmasu J. Siewe, Ph.D., MPH
Health Education and Family Development Specialist

104 HES, NSCI, Room 315

Oklahoma State University

Stillwater, OK 74078
405 744 6825
Siewe@okstate.edu
www.fcs.okstate.edu/health

 

 

References:

Vittinghoff, E.,  Shlipak, M.G.; Varosy P.D. et all, (2003), Risk Factors and Secondary Prevention in Women with Heart disease, Annals of Internal Medicine, Jan 21, vol. 128, (2)
http://www.womens-health.org/

 

 

IMPLICATIONS FOR COOPERATIVE EXTENSION.  Coronary heart disease is the leading cause of death in women over the age of 50, resulting in roughly 500,000 deaths per year.  Realizing that the average FCS client is a menopausal female requires empowering the FCS educator to become an informed front-line interventionist in female-specific health issues, and how to interaction with health care providers.

Introduction.

 

Coronary heart disease is the leading cause of death in women over the age of 50, resulting in roughly 500,000 deaths per year, according to the American Heart Association. Despite the numbers, relatively few studies have included women as subjects. And while the medical community recognizes this gender gap and is making efforts to include more women in large-scale clinical trials, this study reveals a disparity in the treatment of women with heart disease.  The report is based on a study of women who had great access to health care, but revealed a significant number who were not treated appropriately."

 

Women may be getting the shorter end of the stick and the whole system needs to do better. The health care system needs to strive to include the entirety of the population in heart disease studies.

Benefits of women-specific studies and follow-up.

The Heart and Estrogen/progestin Replacement Study (HERS), was designed to examine the benefits of estrogen and progestin in the prevention of cardiovascular events in women with pre-existing heart disease. Although the study did not prove any heart-protective benefit from the estrogen therapy, a tremendous amount of data was produced on risk factors and use of medication. The researchers used the information already collected to assess the long-term effects of risk factors and treatment in women who have pre-existing heart disease.

What researchers found in women with a history of heart disease and recommend:

·         The risk of fatal and non-fatal heart attacks increases up to 6 times when other factors such as diabetes, lack of exercise, high cholesterol and high blood pressure are present.

·         Preventive drugs are underused in this population, especially among women at highest risk.

·         Risk factors for coronary heart disease have been clearly delineated in men, but there is a wide gap in the understanding of risk factors affecting women.

·         Both men and women with diabetes often have other conditions like high blood pressure and high cholesterol, placing them at greater risk for heart disease.

·         According to the American Heart Association, diabetes doubles the risk of a second heart attack in women but not in men.

·         High levels of triglycerides, the most common chemical form of fat in food and in the body, are a risk factor for women over 50 but not for men.

·         Important gender differences can also play a role in the management and treatment of heart disease.

·         Some factors unique to women must be understood: angina (chest pain) may be more atypical; diabetes and hypertriglyceridemia may be more important risk factors and need more aggressive treatment; and we are still trying to figure out the proper way to handle menopause.

·         Some women may experience shortness of breath, dizziness and nausea, rather than typical symptoms experienced by men such as crushing chest pain; the unfamiliarity may lead to misdiagnosis and a delay in proper management and treatment.

·         Women and their doctors need to be better educated and more motivated about secondary prevention' or strategies to prevent heart attacks and death among those who have already had a heart attack or other form of coronary heart disease,

Conclusion.

This study underscores the need for women to be an active part of their own care. Women who have had a heart attack should ask their health care providers for the ABC's of secondary prevention.  Unless there is a contraindication, they all should be taking Aspirin, Beta blockers and Cholesterol lowering drugs. They should also pursue a healthy lifestyle which includes not smoking, engaging in physical exercise, and avoiding obesity through healthy dietary practices.