Top Things to Know: Promoting Risk Identification and Reduction of CVD in Women Through Collaboration with Obstetricians and Gynecologists

Published: May 10, 2018

In 2001, the Institute of Medicine published “Exploring the Biological Contributions to Human Health: Does Sex Matter?” which described the importance of both sex and gender on human biology and physiology.
Gender specific medicine recognizes gender differences and similarities in cardiovascular disease (CVD), including recognition, prevention and management.
Large improvements have been seen in morbidity and mortality rates in women over the past few decades, due in part to the American Heart Association’s (AHA) Go Red for Women campaign that focuses on raising awareness of heart disease and stroke in women.
However, gender-based inequalities still exist, with women being less likely to receive guideline-recommended diagnostic testing and therapies.
Heart disease still remains the number one killer of women; yet in one survey, only 45% of US women identify heart disease as their leading cause of death, and less than one-half of primary care physicians consider CVD as a high concern for women.
Not only are women at risk for the more traditional risk factors associated with atherosclerotic cardiovascular disease (ASCVD), such as hypertension, diabetes, high cholesterol and obesity, but also have non-traditional risks for ASCVD specific to them.
Non-traditional risk factors for women may include those related to pregnancy or hormonal influences. Examples include complications of pregnancy such as preeclampsia, gestational diabetes, gestational hypertension, pre-term delivery and low-for-estimated-gestational birth weight. All indicate a future increase in CV risk for women.
Women who use oral contraceptives and smoke cigarettes have a 7-fold increase in CV risk, and hypertensive women are likely to have elevations in blood pressure related to oral contraceptive therapy.
With OB/GYNs as primary healthcare providers, a well-woman visit offers an important opportunity to counsel patients about healthy lifestyle choices and with this minimizing health risks.
This paper strongly suggests the following for women:
1. Healthy lifestyles and behaviors should be a point of emphasis in the care of all women.
2. Screening for CVD and CV risk factors in women should be enhanced.
3. Providers and healthcare systems should leverage technology to improve the CV health of women.
4. OB/GYN and Cardiology providers can improve the CV health of women through enhanced collaboration between healthcare providers.

View the summary for Promoting Risk Identification and Reduction of Cardiovascular Disease in Women Through Collaboration

Citation

Brown HL, Warner JJ, Gianos E, Gulati M, Hill AJ, Hollier LM, et al; on behalf of the American Heart Association and the American College of Obstetricians and Gynecologists. Promoting risk identification and reduction of cardiovascular disease in women through collaboration with obstetricians and gynecologists: a presidential advisory from the American Heart Association and the American College of Obstetricians and Gynecologists [published online ahead of print May 10, 2018]. Circulation. DOI: 10.1161/CIR.0000000000000582.