Febuary 9, 2007

Commentary:

Heart disease in women is prevalent, serious

By Dr. Jennifer Mieres

February is American Heart Month, and it serves as an important reminder of the need to address the impact of heart disease on women.

Every minute in this country, someone’s mother, sister, wife or friend will die from heart disease, stroke and other cardiovascular diseases. These diseases have been the No. 1 killer of American women for more than 40 years, with minority women especially vulnerable.

Yet there are too many people in this country — including health care professionals, researchers, policy-makers and women — who still mistakenly consider cardiovascular disease to be a man’s disease.

Only 8 percent of primary care physicians recognized that heart disease kills more women each year than men, according to a recent American Heart Association (AHA) survey. Unfortunately this information gap results in women receiving less aggressive and sophisticated diagnostic screening and treatments, like stents and angioplasties, which could prevent a deadly heart attack or stroke.

Among women, only 55 percent recognize that cardiovascular disease is the leading cause of death for their sex, according to another AHA survey. Many more are uninformed about the symptoms of cardiovascular disease, which can be more subtle than those exhibited by men. And many don’t realize that such controllable conditions like smoking, physical inactivity or high blood pressure can put them at increased risk for heart attack or stroke.

This knowledge gap disproportionately impacts minority women. Only 38 percent of African-American women recognize that heart disease is their biggest health threat, even though nearly half of all African-American women (49 percent) have some form of cardiovascular disease (compared to 35 percent of white women).

They are also more likely to have many of the risk factors for cardiovascular disease, including diabetes, high cholesterol, high blood pressure and physical inactivity. Much the same is true for Hispanic women.

But even when women and their doctors recognize the need for medical intervention for cardiovascular disease, they often don’t know if the treatments and medications available are equally effective or even safe for women.

That’s because previous scientific studies were frequently conducted with inadequate numbers of women in the study population, meaning their findings don’t always apply to women. In fact, women represent just 38 percent of subjects in National Institutes of Health-sponsored cardiovascular studies, and one-third of all the new drugs approved by the Food and Drug Administration in recent years have not included information about how they affect women.

Federal officials need to take action to help reduce disability and death from cardiovascular diseases in women. There are several ways they can achieve this goal.

Congress needs to authorize grants to educate both women and health care providers about prevention programs and the most effective diagnostic and treatment strategies for cardiovascular disease in women.

Second, lawmakers must tighten FDA requirements for drug companies and device manufacturers to report gender-based data.

Third, they must expand the Centers for Disease Control and Prevention’s free screening program for low-income, uninsured women to all 50 states. Currently this program covers only 14 states.

The prevalence of cardiovascular disease in women is a national problem, and we need a national approach. We must help reduce the devastating effects of this disease in women to ensure that our loved ones have the opportunity to live longer, healthier lives.

Dr. Jennifer Mieres is a practicing cardiologist and director of Nuclear Cardiology at New York University School of Medicine. She is also an American Heart Association volunteer and supports the HEART for Women Act, a bipartisan federal legislation to combat heart disease in women (www.heartforwomen.org). She can be reached at pmproj@progressive.org.

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