Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Updated heart disease prevention guidelines for women focus more on 'real-world' recommendations

15.02.2011
Practical medical advice that works in the "real world" may more effectively prevent cardiovascular disease in women than recommendations based only on findings in clinical research settings, according to the 2011 update to the American Heart Association's cardiovascular disease prevention guidelines for women.

First published in 1999, the guidelines until now have been primarily based on findings observed in clinical research. That alone often doesn't consider the personal and socioeconomic factors that can keep women from following medical advice and treatment.

"These recommendations underscore the fact that benefits of preventive measures seen day-to-day in doctors' offices often fall short of those reported for patients in research settings," said Lori Mosca, M.D., M.P.H., Ph.D., chair of the guidelines writing committee and a medical advisor for the American Heart Association's Go Red For Women movement. "Many women seen in provider practices are older, sicker, and experience more side effects than patients in research studies. Factors such as poverty, low literacy level, psychiatric illness, poor English skills, and vision and hearing problems can also challenge clinicians trying to improve their patients' cardiovascular health."

The 2011 update identifies barriers that hinder both patients and doctors from following guidelines, while outlining key strategies for addressing those obstacles.

"Awareness continues to be a key driver to optimal care," said Mosca, director of preventive cardiology at New York-Presbyterian Hospital and professor of Medicine at Columbia University Medical Center. "Cause initiatives such as Go Red for Women and provider compliance programs such as Get With The Guidelines® are strong components in our efforts to broaden awareness and improve adherence among patients and providers."

She said getting a dialogue started between a woman and her doctor is a critical first step.

"If the doctor doesn't ask the woman if she's taking her medicine regularly, if she's having any side effects or if she's following recommended lifestyle behaviors, the problems may remain undetected," she said. "Improving adherence to preventive medications and lifestyle behaviors is one of the best strategies we have to lower the burden of heart disease in women."

To evaluate patient risk, the guidelines incorporate illnesses linked to higher risk of cardiovascular disease in women, including lupus and rheumatoid arthritis, and pregnancy complications such as preeclampsia, gestational diabetes or pregnancy-induced hypertension. Mosca said women with a history of preeclampsia face double the risk of stroke, heart disease and dangerous clotting in veins during the five to 15 years after pregnancy. Essentially, having pregnancy complications can now be considered equivalent to having failed a stress test.

"These have not traditionally been top of mind as risk factors for heart disease," she said. "But if your doctor doesn't bring it up, you should ask if you're at risk for heart disease because of pregnancy complications or other medical conditions you've experienced."

The updated guidelines also emphasize the importance of recognizing racial and ethnic diversity and its impact on cardiovascular disease. For example, hypertension is a particular problem among African-American women and diabetes among Hispanic women.

Although putting clinical research into practical, everyday adherence can be challenging, solid scientific evidence is still the basis for many of the guidelines, Mosca said. Some commonly considered therapies for women are specifically noted in the guidelines as lacking strong clinical evidence in their effectiveness for preventing cardiovascular disease and, in fact, may be harmful to some women. Those include the use of hormone replacement therapy, antioxidants and folic acid.

The update includes depression screening as part of an overall evaluation of women for cardiovascular risk, because while treating depression has not been shown to directly improve cardiovascular health, depression might affect whether women follow their doctor's advice.

Despite a growing body of clinical evidence to fight heart disease and stroke in women, more is needed, Mosca said. Coronary heart disease death rates in women dropped by two-thirds from 1980 to 2007, due to both effective treatment and risk factor reduction, according to the American Heart Association, but cardiovascular disease still kills about one woman every minute in the United States.

In future studies, researchers should look at interventions during specific times throughout a woman's lifespan ― including puberty, pregnancy and menopause ― to identify risks and determine effective prevention opportunities during those critical times, Mosca said. More cost-effective analyses and clinical trial research with male- and female-specific results are also needed, especially regarding risks posed by preventive therapies.

"Now that science has shown the benefits are often similar for men and women, there is a need to understand if the risks are also similar and acceptable," she said.

"These guidelines are a critical weapon in the war against heart disease, the leading killer of women," Mosca said. "They are an important evolution in our understanding of women and heart disease. And I cannot stress personal awareness and education enough. Initiatives such as Go Red For Women give women access to the latest information and real-life solutions to lower their risk of heart disease."

Other authors include Emelia J. Benjamin, M.D., Sc.M.; Kathy Berra, M.S.N., N.P.; Judy L. Bezanson, D.S.N., C.N.S.-M.S.; Rowena J. Dolor, M.D., M.H.S.; Donald M. Lloyd-Jones, M.D., Sc.M.; L. Kristin Newby, M.D., M.H.S.; Ileana L. Piña, M.D., M.P.H.; Véronique L. Roger, M.D., M.P.H.; Leslee J. Shaw, Ph.D.; and Dong Zhao, M.D., Ph.D. Author disclosures are on the manuscript.

The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association's science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical companies and device manufacturers, is available at www.heart.org/corporatefunding.

Cathy Lewis | EurekAlert!
Further information:
http://www.heart.org

More articles from Health and Medicine:

nachricht 'Living bandages': NUST MISIS scientists develop biocompatible anti-burn nanofibers
16.02.2018 | National University of Science and Technology MISIS

nachricht New process allows tailor-made malaria research
16.02.2018 | Eberhard Karls Universität Tübingen

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Demonstration of a single molecule piezoelectric effect

Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale

Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...

Im Focus: Hybrid optics bring color imaging using ultrathin metalenses into focus

For photographers and scientists, lenses are lifesavers. They reflect and refract light, making possible the imaging systems that drive discovery through the microscope and preserve history through cameras.

But today's glass-based lenses are bulky and resist miniaturization. Next-generation technologies, such as ultrathin cameras or tiny microscopes, require...

Im Focus: Stem cell divisions in the adult brain seen for the first time

Scientists from the University of Zurich have succeeded for the first time in tracking individual stem cells and their neuronal progeny over months within the intact adult brain. This study sheds light on how new neurons are produced throughout life.

The generation of new nerve cells was once thought to taper off at the end of embryonic development. However, recent research has shown that the adult brain...

Im Focus: Interference as a new method for cooling quantum devices

Theoretical physicists propose to use negative interference to control heat flow in quantum devices. Study published in Physical Review Letters

Quantum computer parts are sensitive and need to be cooled to very low temperatures. Their tiny size makes them particularly susceptible to a temperature...

Im Focus: Autonomous 3D scanner supports individual manufacturing processes

Let’s say the armrest is broken in your vintage car. As things stand, you would need a lot of luck and persistence to find the right spare part. But in the world of Industrie 4.0 and production with batch sizes of one, you can simply scan the armrest and print it out. This is made possible by the first ever 3D scanner capable of working autonomously and in real time. The autonomous scanning system will be on display at the Hannover Messe Preview on February 6 and at the Hannover Messe proper from April 23 to 27, 2018 (Hall 6, Booth A30).

Part of the charm of vintage cars is that they stopped making them long ago, so it is special when you do see one out on the roads. If something breaks or...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

2nd International Conference on High Temperature Shape Memory Alloys (HTSMAs)

15.02.2018 | Event News

Aachen DC Grid Summit 2018

13.02.2018 | Event News

How Global Climate Policy Can Learn from the Energy Transition

12.02.2018 | Event News

 
Latest News

Fingerprints of quantum entanglement

16.02.2018 | Information Technology

'Living bandages': NUST MISIS scientists develop biocompatible anti-burn nanofibers

16.02.2018 | Health and Medicine

Hubble sees Neptune's mysterious shrinking storm

16.02.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>