Heart disease remains the number killer of women in the United States; and the rate of decline in heart disease has been less prevalent among women. Approximately one woman dies every minute from heart disease in this country. Every year since 1984 more women have died of heart disease than men yet many women are still unaware of their biggest health threat. The National Heart Lung and Blood Institute\’s Red Dress/Heart Truth campaign which began in 2001 and the American Heart Association\’s Go Red campaign which began in 2004 were both developed to educate and increase women\’s awareness of heart disease. How well are we doing? The American Heart Association conducted random surveys in 1997, 2000, and 2003 asking women to identify their leading cause of death. The percentage answering correctly was 30%, 34%, and 46%, respectively. The most recent Lifetime Poll released in February 2006 found that only 54% of the women surveyed were able to correctly identify heart disease as their leading cause of death. Among those who correctly identified heart disease as the leading cause of death, the majority still perceived cancer as their greatest health risk. Even though awareness overall among women has significantly increased, there is still a large population of women who are unaware of their risk and women who are not personalizing this information.

In February of 2004 the American Heart Association published for the first time specific guidelines for cardiovascular disease prevention in women. A random national study of primary care physicians (PCP), OB-GYN physicians, and cardiologists was conducted in November of 2004 to evaluate physician awareness and adherence to these gender specific guidelines. Approximately 60% of the PCPs and OB-GYNs, and 80% of the cardiologists stated they were aware of the women\’s heart disease preventative guidelines. Of the physicians who were aware of the guidelines only about 40% of the PCPs and cardiologists, and only 20% of the OB-GYNs stated they actually utilized the guidelines in the care of their female patients. Another alarming finding from this study was that only 8% of PCPs, 13% of OB-GYNs, and 17% of cardiologists knew that heart disease kills more women than men every year. In order to effectively modify heart disease risk factors and decrease heart disease mortality in women healthcare providers require additional education.

Information like this is exactly what prompted this article. As nurses we are on the forefront, we are vital patient advocates and patient educators. February is National Heart Month and February 6, 2009 is National Wear Red Day. We all need to work together to educate women about heart disease risk factors.

The majority of the risk factors that can lead to the development of heart disease are similar for both men and women. (See Risk Factor table) One unique risk factor women experience is menopause. Prior to menopause, estrogen protects most women from developing heart disease. After menopause (and the loss of estrogen), a clustering of heart disease risk factors occurs (including dyslipidemia, hypertension, and weight gain) which dramatically increases a woman\’s risk for heart attacks and strokes. Clinical research studies have found that eighty percent of heart attacks are preventable by controlling and optimizing risk factors. It is imperative that women of all ages evaluate their risk factors (especially prior to menopause) in order to decrease their risk of developing heart disease. We need to empower women to identify their individual risk factors and make the necessary lifestyle changes, and what better time than during National Heart Month.

There are a lot of excellent resources available (see Women and Heart Disease Online Resource table) to assist both women and healthcare professionals to increase their awareness/knowledge of heart disease. Knowledge is Power. By working together we can make a dramatic impact on decreasing the incidence of heart disease among women.

RISK FACTORS FOR HEART DISEASE:

Non-modifiable risk factors:
1) Increased age
2) Family history of heart disease

Modifiable risk factors:
1) Dyslipidemia
2) Hypertension
3) Physical inactivity
4) Overweight/Obesity
5) Smoking
6) Emotional stress
7) Diabetes/Metabolic syndrome

I am a cardiac nurse practitioner specializing in heart disease prevention. I want to help you live a longer healthier life. Brand new book “Take Charge: A Woman\’s Guide to a Healthier Heart” due out Feb 2009.
For more information please visit www.heart-strong.com
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Visit my blog Healthy Hearts with Heartstrong blog

WOMEN AND HEART DISEASE FREE ONLINE RESOURCES:

American Heart Associations Go Red Campaign (Go Red)
Heartstrong (Heartstrong)
NHLBI Heart Truth Campaign (Truth Campaign)
Preventive Cardiovascular Nurses Association (PCNA)
Women\’s Heart Foundation (WHF)

References:

American Heart Association. Heart Disease and Stroke Statistics—2008 Update. Dallas, Tex: American Heart Association; 2008.

Mosca, L, Mochari, H., Christian, A., et.al. National study of women\’s awareness, preventive action, and barriers to cardiovascular health. Circulation. 2006, 113: 525-534.

Mosca, L., Appel, A., Benjamin, E., et.al. Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women. Circulation. 2004, 109: 672-693.

Mosca, L., Linfante, A., Benjamin, E., et.al. National Study of Physician Awareness and Adherence to Cardiovascular Disease Prevention Guidelines. Circulation. 2005, 111: 499-510.

Mosca, L., Manson, J., Sutherland, S., et.al. Cardiovascular Disease in Women a Statement for Healthcare Professionals from the American Heart Association. Circulation. 1997, 96: 2468-2482.

Carolyn Strimike is a cardiac nurse practitioner with over 20 years of nursing experience. She specializes in heart health and wellness and is co-founder of Heartstrong, LLC a healthcare education and consulting business.