Preventing heart disease in women—results from the conference, “Women and Heart Disease: Putting Prevention Into Primary Care”

Abstract

W do so many women remain unaware of their risk for heart disease? As diagnosis and management of coronary heart disease have improved, why haven’t women experienced as dramatic a decrease in morbidity as men? Why do women receive fewer preventive services than are recommended? What barriers do health providers face in providing women the highest quality care for prevention of heart disease? To answer these questions, the Jacobs Institute of Women’s Health launched its innovative and groundbreaking Women’s Heart Initiative to increase awareness and improve prevention of heart disease in women. The Initiative was launched in response to recommendations from a multidisciplinary panel of experts convened by the Jacobs Institute, the National Institutes of Health’s Office of Research on Women’s Health, and the Agency for Healthcare Research and Quality (AHRQ). The panel concluded that the management, diagnosis, and treatment of heart disease in women were poorly understood and that services were often implemented unevenly. The result is that women receive poorer care. The Jacobs Institute convened a multidisciplinary conference of experts to determine how existing knowledge about women and heart disease could be more consistently and fully applied in practice, sponsored by Pfizer Inc. Women’s Health, the Fannie E. Rippel Foundation, and AHRQ. The conference identified barriers at the provider, patient, and systems levels that prevent women from receiving recommended preventive services and identified ways to eliminate these barriers. The Jacobs Institute commissioned three papers for the conference on the topics: the prevention of heart disease through health behavior change, physician adherence to preventive cardiology guidelines, and quality of care measures for heart disease in women; these papers are included in this issue. Experts at the conference concluded that not enough is being done to prevent heart disease in women and that there are steps that can be taken to improve prevention. Those steps and recommendations are unveiled for the first time in this issue. They address multiple areas including clinical practice, research, quality improvement, and public policy. Conference participants also identified the need for a comprehensive public health action plan for preventing heart disease in women. Given the large number of women at risk for heart disease, the lack of awareness among both women and their health care professionals, and the failure to utilize strategies proven to reduce women’s risk, a prevention action plan specifically addressing women is warranted. While organizations such as the National Heart, Lung, and Blood Institute have laid important groundwork, a comprehensive plan can promote work at the national, state, and local levels to improve public policy and encourage collaboration among key government agencies, professional associations, advocacy organizations, and women. Recommendations gained from the conference can form the basis for a national agenda that will advance the prevention of heart disease. The Jacobs Institute hopes and expects that these recommendations will become a framework for further work on women and heart disease and will send the message to policymakers, researchers, health plans, providers, and women that much more can be done to prevent heart disease in women. Women’s Health Issues 13 (2003) 114