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

Brown, Haywood L.; Warner, John J.; Gianos, Eugenia; Gulati, Martha; Hill, Alexandria J.; Hollier, Lisa M.; Rosen, Stacey E.; Rosser, Mary; Wenger, Nanette K.

doi:10.1161/cir.0000000000000582

Cited by 266 publications

(164 citation statements)

References 61 publications

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“…This result indicates that the co-existence of multiple risk factors is the main cause for the occurrence of ACS in young women. It has been reported that gynecological diseases combined with cardiovascular disease (such as hypertension) and diabetes increase the risk of ischemic heart disease by two times [17] .The patients who smoke and also take oral contraceptives have a seven-fold increased risk of developing arteriosclerotic cardiovascular disease [18] The results of this study also showed that the smoking rate of ACS patients was significantly higher than that of the control group (P < 0.05).…”

Section: Discussionsupporting

confidence: 56%

The Characteristics of Risk Factors in Chinese Young Women with Acute Coronary Syndrome

Liu

Zhou

et al. 2020

Preprint

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Background In recent years, the prevalence rate of ACS in Chinese young women has been increasing significantly, becoming the main cause of death in young female. This study aimed to investigate the characteristics and difference of risk factors in Chinese young women with ACS and to provide references for ACS prevention and treatment. Methods A 1:1 case-control study was conducted to evaluate risk factors of 415 young female patients with ACS (ACS group) who underwent PCI treatment and 415 young female cases without ACS (control group) who were hospitalized and confirmed by coronary angiography to exclude coronary heart disease from January 2010 to August 2016. The average age of the cases in the two groups was respectively (40.77±4.02) years-old and (40.57±4.01) years-old (P> 0.05). Results The risk factors in ACS group were overweight (64.10%), hypertension (49.88%), hyperlipidemia (35.66%), diabetes (23.37%), depression or anxiety disorder (16.62%), gynecological diseases (16.39%), Hyperuricemia (15.18%), family history of early onset coronary heart disease (14.94%), hyperhomocysteinemia (11.33%), hypothyroidism(14.96%), hypercholesterolemia (8.43%) and high c-reactive protein (7.47%), and were statistically significant difference (P<0.01) compared with that of control group. The average number of risk factors per case in ACS group was significantly more than that of control groups (P<0.01). There was a statistically significant difference in the number of combined risk factors of the overweight cases compared between two groups (P<0.01). Regression analysis showed that hyperlipidemia, hyperhomocysteinemia, overweight（obesity）, high CRP, hypertension, hypothyroidism, gynecological diseases, depression or anxiety, cardiac insufficiency, hypercholesterolemia, diabetes, oral contraceptives, family history of early onset CHD, and autoimmune diseases were independent risk factors (P<0.01). The bivariate correlation analysis between CRP level and age was r= -0.158 (P<0.01). This result showed the younger ACS patient is the higher serum CRP. Conclusion The independent risk factors of ACS in young women are hyperlipidemia, hyperhomocysteinemia, overweight, high CRP, hypertension, hypothyroidism, gynecological diseases, depression or anxiety, cardiac insufficiency, hypercholesterolemia, diabetes, oral contraceptives, family history of early onset CHD, and autoimmune diseases. The co-existence of multiple risk factors is the main cause suffering from ACS in young women.

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Section: Discussionsupporting

confidence: 56%

The Characteristics of Risk Factors in Chinese Young Women with Acute Coronary Syndrome

Liu

Zhou

et al. 2020

Preprint

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“…In light of the current pressures on primary care in the UK, it may be timely to consider alternative models of postpartum CVD risk assessment and support of longer‐term lifestyle changes. In the USA, there have been calls for greater cooperation between obstetricians and cardiologists to identify high‐risk women and initiate preventive care . The AHA describes an optimal, well‐woman, cardiovascular prevention visit as including taking a thorough family history, screening for CVD risk factors (especially those unique to women) and lifestyle counselling .…”

Section: Resultsmentioning

confidence: 99%

“…48 The AHA describes an optimal, wellwoman, cardiovascular prevention visit as including taking a thorough family history, screening for CVD risk factors (especially those unique to women) and lifestyle counselling. 48 The frequency with which these well-woman visits should occur depends on the presence or absence of risk factors, but the postpartum visit should be considered an opportunity to focus on lifestyle modification, such as weight management and smoking cessation, to improve cardiovascular health. In Ontario, Canada, a Maternal Health clinic has been established for women who had pregnancy complications placing them at higher cardiovascular risk.…”

Section: Resultsmentioning

confidence: 99%

The obstetrician's role in preventing cardiometabolic disease

Hirst

Nagraj

Henry

et al. 2019

The Obstetric & Gynaecologis

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Key content Cardiovascular diseases are the leading causes of death in women and account for the majority of deaths in women living in the UK. Pregnancy is a ‘stress test’ for cardiometabolic conditions, identifying women at increased risk during and after pregnancy. Antenatal and postnatal care may therefore be key times for primary and secondary prevention. Given the growing burden of cardiometabolic diseases, pressure is mounting to integrate screening, management and preventive programmes into maternity services. Learning objectives To be familiar with the long‐term consequences that can follow gestational diabetes and hypertensive diseases of pregnancy. To understand the evidence for interventions before and after birth to prevent future morbidity and mortality. To recognise the important role of obstetricians in linking secondary care with primary and preventive care services to prevent cardiovascular and metabolic diseases. Ethical issues What is the role of the obstetrician in contributing to women's lifelong wellbeing?

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“…16 Over the past decade, additional published guidelines, scientific statements, and advisories have increasingly addressed the following aspects of CVD in women: peripheral artery disease (2012), 5,17 trends in awareness of heart disease in women (2013), 18 stroke prevention in women (2014), 19 role of noninvasive testing in the clinical evaluation of women with suspected ischemic heart disease (2005) and updated in 2014, 20,21 acute myocardial infarction (2016), prevention and experience of ischemic heart disease (2016), 22 spontaneous coronary artery dissection (2018), 23 and promotion of risk identification and reduction of CVD in women through collaboration with obstetricians and gynecologists (2018). 24 All of these documents consistently report that the level of evidence is not available at this time to provide sex-based guidelines for treatment of heart events in women. It is also interesting to note that there are no women-focused statements/ guidelines on heart failure, arrhythmias, or valve diseases.…”

Section: Clinical Practice Guidelines For Women With Cvdmentioning

confidence: 99%

Introducing the Canadian Women’s Heart Health Alliance ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Diseases in Women

et al. 2020

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Despite a global understanding that indicators and outcomes of cardiovascular disease (CVD) are known to differ between men and women, uptake of the recognition of sex and gender influences on the clinical care of women has been slow or absent. The Canadian Women's Heart Health Alliance (CWHHA) was established as a network of experts and advocates to develop and disseminate evidence-informed strategies to transform clinical practice and augment collaborative action on women's cardiovascular health in Canada. As an initial project, the CWHHA membership undertook an environmental scan of CVD in women in Canada from which a scientific statement could be developed to summarize critical sex-and gender-specific issues in CVD. This comprehensive review of the CJC Open 2 (2020) 145e150

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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

Cited by 266 publications

References 61 publications

The Characteristics of Risk Factors in Chinese Young Women with Acute Coronary Syndrome

The Characteristics of Risk Factors in Chinese Young Women with Acute Coronary Syndrome

The obstetrician's role in preventing cardiometabolic disease

Introducing the Canadian Women’s Heart Health Alliance ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Diseases in Women

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