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Rates, Risks and Disparities

Love is in the air – the landscape is covered with hearts to celebrate. But are we loving our own hearts enough? Statistics would say no. As one of the key partners to the American Heart Association, WomenHeart has done much to raise awareness of heart disease and its prevalence in women. Their Ready in Red campaign focuses on heart disease as the #1 killer of women in the U.S. and encourages women to take charge of their heart health. But there is much to be done.

Risk Factors for Women Which Must be Addressed * Smoking * Hypertension * Diabetes mellitus * Dyslipidemia * Overweight/obesity * Menopause * Family History * High levels of C-reactive protein * Depression * Stress

Though progress continues, the statistics are still sobering– one of every 4 women will develop heart disease and die of it in the U.S., yet less than 21 percent of women think heart disease is their greatest health threat. And women are not the only uninformed segment. As recently as 2005, an American Heart Association study indicated that only 8 percent of primary care physicians and 17 percent of cardiologists knew that heart disease kills more women than men.

Cardiovascular disease kills more women than all other diseases, including all cancers, chronic lower respiratory disease, Alzheimer’s disease and accidents combined. Every minute, a woman dies of heart disease.

Further statistics from the AHA Heart and Stroke report released in December, and WomenHeart resources show:

* There are 42.7 million women at risk or living with heart disease (this represents 35 percent of the female population); 8 million women have heart disease
* Since 1984, more women than men die of heart disease in the U.S.
* Sixty-four percent of women who died suddenly from coronary artery disease had no previous symptoms
* Thirty-eight percent of women will die within one year of having a heart attack
* Women over 40 have a lifetime risk of 1 in 4 for developing atrial fibrillation
* Cigarette smoking results in a 2-3 fold risk of dying from coronary heart disease
* Women comprise only 27 percent of participants in all heart-related research studies
* The total cost of CV disease for 2010 – $503.2 billion, including all ages and genders.

Women with diabetes are 2-3 times more likely to have a heart attack, and diabetes doubles the risk of a second heart attack. With 62 percent of U.S. adult women overweight or obese, their risk of diabetes and heart disease is compounded. African-American women have diabetes at twice the rate of Caucasian women which increases the risk of heart disease, a common co-existing condition.

Resources on the Web www.framinghamheartstudy.org/risk/index.html www.scai.org www.seconds-count.org www.americanheart.org www.womenheart.org

Heart disease is less understood in women and they face additional challenges due to delays in symptom recognition and incorrect treatment; delays or misdiagnosis due to lower adherence to proven guidelines (Circulation. 2007; 115: 1481-1501); lower use of meds, such as aspirin, beta blockers, ACE inhibitors and statins; and lower use of angiography and revascularization.

Symptoms may be atypical from their male counterparts. Studies have found that women are at a higher risk of stroke than men. Women are more likely than men to have atrial fibrillation (AF), a major cause of stroke. Strokes caused from clots due to AF are more debilitating, often resulting in disability or death. Menopause brings unique health issues to women, and adds another risk factor to for heart disease. Women are also less likely to be referred to cardiac rehab than men. These factors combined contribute to increased mortality in women who are more likely to die of their disease.

“If we are on top of our risk factors, we can prevent 85 percent of cardiovascular disease in women,” according to Tracy Stevens, MD, Director of St. Luke’s Muriel I. Kauffman Women’s Heart Center in Kansas City, Mo. and a member of the scientific advisor council for WomenHeart. “We must take ownership of our risk factors. Many women are in denial.”

Have you loved your heart today?

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FACC St. Luke’s Muriel I. Kauffman Women’s Heart Center Women and hear, MD, Tracy Stevens

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