Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women

Significant advances in our knowledge about interventions to prevent cardiovascular disease (CVD) have occurred since publication of the first female-specific recommendations for preventive cardiology in 1999.1 Despite research-based gains in the treatment of CVD, it remains the leading killer of women in the United States and in most developed areas of the world.2–3 In the United States alone, more than one half million women die of CVD each year, exceeding the number of deaths in men and the next 7 causes of death in women combined. This translates into approximately 1 death every minute.2 Coronary heart disease (CHD) accounts for the majority of CVD deaths in women, disproportionately afflicts racial and ethnic minorities, and is a prime target for prevention.1–2 Because CHD is often fatal, and because nearly two thirds of women who die suddenly have no previously recognized symptoms, it is essential to prevent CHD.2 Other forms of atherosclerotic/thrombotic CVD, such as cerebrovascular disease and peripheral arterial disease, are critically important in women. Strategies known to reduce the burden of CHD may have substantial benefits for the prevention of noncoronary atherosclerosis, although they have been studied less extensively in some of these settings

Effectiveness-based guidelines for the prevention of cardiovascular disease in women-2011 update: A Guideline from the American Heart Association

"Substantial progress has been made in the awareness, treatment, and prevention of cardiovascular disease (CVD) in women since the first women-specific clinical recommendations for the prevention of CVD were published by the American Heart Association (AHA) in 1999.1 The myth that heart disease is a “man's disease” has been debunked; the rate of public awareness of CVD as the leading cause of death among US women has increased from 30% in 1997 to 54% in 2009.2 The age-adjusted death rate resulting from coronary heart disease (CHD) in females, which accounts for about half of all CVD deaths in women, was 95.7 per 100 000 females in 2007, a third of what it was in 1980.3,4 Approximately 50% of this decline in CHD deaths has been attributed to reducing major risk factors and the other half to treatment of CHD including secondary preventive therapies.4 Major randomized controlled clinical trials such as the Women's Health Initiative have changed the practice of CVD prevention in women over the past decade.5 The investment in combating this major public health issue for women has been significant, as have the scientific and medical achievements. Despite the gains that have been made, considerable challenges remain. In 2007, CVD still caused ≈1 death per minute among women in the United States.6 These represent 421 918 deaths, more women's lives than were claimed by cancer, chronic lower respiratory disease, Alzheimer disease, and accidents combined.6 Reversing a trend of the past 4 decades, CHD death rates in US women 35 to 54 years of age now actually appear to be increasing, likely because of the effects of the obesity epidemic.4 CVD rates in the United States are significantly higher for black females compared with their white counterparts (286.1/100 000 versus 205.7/100 000). This disparity parallels the substantially lower rate of awareness of heart disease and stroke that has been documented among black versus white women.2,6–8 Of concern is that in a recent AHA national survey, only 53% of women said the first thing they would do if they thought they were having a heart attack was to call 9-1-1. This distressing lack of appreciation by many women for the need for emergency care for acute cardiovascular events is a barrier to optimal survival among women and underscores the need for educational campaigns targeted to women.2

Looking Forward: Women\u27s Health Research and Careers (Part 2)

Dr. Vivian W. Pinn is the first full-time Director of the Office of Research on Women’s Health (ORWH) at the National Institutes of Health (NIH), an appointment she has held since 1991 and as NIH Associate Director for Research on Women’s Health since 1994.Dr. Pinn came to NIH from Howard University College of Medicine in Washington, D.C., where she had been Professor and Chair of the Department of Pathology since 1982, and has previously held appointments at Tufts University and Harvard Medical School. She has been invited to present the ORWH’s mandate, programs and initiatives to many national and international individuals and organizations with an interest in improving women’s health and the health of minorities. One of her recent areas of focus has been to raise the perception of the scientific community about the importance of sex differences research across the spectrum from the cellular to translational research and implementation into health care. Dr. Pinn is currently co-chair, along with the Director of NIH, of The NIH Working Group on Women in Biomedical Careers which is developing and implementing programs and policies to improve the advancement of women in biomedical careers. Dr. Pinn has just completed a national initiative to reexamine priorities for the women’s health research agenda for the 21st century, involving more than 1500 advocates, scientists, policy makers, educators and health care providers in a series of scientific meetings and public hearings across the country to determine progress as well as continuing, or emerging areas in need of research. This new strategic plan for the coming decade, Moving into the Future with New Dimensions and Strategies: a Vision for 2020 for Women’s Health Research, was presented publicly at the September 2010 scientific symposium and celebration of the 20th anniversary of the ORWH. Dr. Pinn, a native of Lynchburg, Virginia, earned her B.A. from Wellesley College in Massachusetts, and received her M.D. from the University of Virginia School of Medicine in 1967, where she was the only woman and minority in her class. She returned to Massachusetts to complete her postgraduate training in Pathology at the Massachusetts General Hospital, during which time she also served as Teaching Fellow at the Harvard Medical School. She is a member of long standing in many professional and scientific organizations, in which she has held many positions of leadership. Dr. Pinn has held numerous positions in the National Medical Association, including serving as speaker of the House of Delegates, Trustee, and the 2nd woman President in 1989. Dr. Pinn has received numerous honors, awards, and recognitions, and has been granted 11 Honorary Degrees of Laws and Science since 1992. She is a fellow of the American Academy of Arts and Sciences and was elected to the Institute of Medicine in 1995. Among her honors are the Alumni Achievement Award from Wellesley College in 1993, and she served on the Wellesley College Board of Trustees. She also received the second annual Distinguished Alumna Award from the University of Virginia, was honored by the UVA medical school as one of their Alumni Luminaries and was invited to serve as the 2005 speaker for the Universiy of Virginia Commencement. The UVA School of Medicine has established the ‘Vivian W. Pinn Distinguished Lecture in Health Disparities,’ and further honored her in the fall of 2010 by naming one of its four advisory colleges for medical schools in her name