Evaluating and Managing Cardiovascular Disease in Women

Abstract

Despite the efforts of investigators, public health and private caregivers, voluntary health organizations, and policymakers, heart disease continues to be the leading cause of death in women, both in the United States and throughout most of the world.1,2 A number of issues contribute to these disappointing statistics. Many women lack the basic awareness that cardiovascular disease is the leading cause of death among women. The American Heart Association’s (AHA) 2004 survey of women’s attitudes and knowledge showed that, when asked what they thought was the leading cause of death among women, >50% of women answered this question incorrectly.3 Even more important, only 13% of women personalized this information and answered that their own personal greatest health threat was heart disease. Although this level has increased from 7% since the initial survey 6 years ago, it is still far too low. Furthermore, because coronary disease becomes clinically evident in women about a decade later than it does in men, women commonly believe that preventing heart disease can be postponed. They may believe that they can begin to focus on it in their 50s, after other priorities such as childbearing, child rearing, and caring for their families no longer need their full attention. They miss the fact so well demonstrated by the Pathobiological Determinants of Atherosclerosis in Youth studies that atherosclerosis is often evident in women in their 20s, that it is related to classical cardiovascular risk factors, and that preventing …