Specialized Care for Women: the Impact of Women’s Heart Centers

Lundberg, Gina; Mehta, Laxmi S.; Volgman, Annabelle Santos

doi:10.1007/s11936-018-0656-5

Cited by 13 publications

(10 citation statements)

References 36 publications

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“…This study illustrates the very real challenge facing our female patients: the lack of awareness of the risk factors that contribute to heart disease in women. Fewer than one in five physicians know that more women than men die every year from CVD in the US and Australia [6]. Women experiencing a myocardial infarction present later and receive less timely intervention, compared to men [7].…”

Section: Discussionmentioning

confidence: 99%

Previous Pre-Eclampsia, Gestational Diabetes and Hypertension Place Women at High Cardiovascular Risk: But Do We Ask?

Aslam

Perera

Watts

et al. 2021

Heart, Lung and Circulation

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BackgroundWomen who experience vascular complications of pregnancy, including pre-eclampsia, hypertension and diabetes, are at increased risk of coronary artery disease (CAD). Yet patients and their medical providers have low awareness of the significance of these 'non-traditional' cardiovascular risk factors. We aimed to determine the prevalence and medical provider awareness of pregnancy-related cardiovascular risk factors in women with CAD. MethodsWomen aged 18-70 years treated with percutaneous coronary intervention (PCI) across three tertiary hospitals were invited to participate in a pregnancy-related telephone interview at 12 months post-PCI. Electronic medical records (EMR) were retrospectively reviewed for documentation of pregnancy-related cardiovascular risk factors in the 12 months prior to, and including, the PCI admission. ResultsA total of 102 women (mean age 59.867.7 years) underwent PCI for CAD and completed the pregnancy history questionnaire. Approximately three-quarters (73.5%, 75/102) of women had been pregnant, of which 25.3% (19/75) had experienced vascular complications consisting of pre-eclampsia 31.5% (6/19), gestational diabetes 36.8% (7/19), and gestational hypertension 73.6% (14/19). Documentation of traditional CVD risk factors occurred in 209/211 episodes of emergency or cardiology contact (99.1%), while documentation of 'non-traditional' pregnancy-related cardiovascular risk factors occurred in 0/211 episodes of emergency or cardiology contact. ConclusionMore than a quarter of women treated with PCI for CAD had experienced a past pregnancy-related vascular complication. Despite vascular complications of pregnancy predicting future CAD, medical providers were not obtaining a history of these 'non-traditional' cardiovascular risk factors.

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Section: Discussionmentioning

confidence: 99%

Previous Pre-Eclampsia, Gestational Diabetes and Hypertension Place Women at High Cardiovascular Risk: But Do We Ask?

Aslam

Perera

Watts

et al. 2021

Heart, Lung and Circulation

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“…Previously there has been almost complete exclusion of women of childbearing age from interventionbased CVD trials (particularly pharmacotherapeutic trials) [33][34][35][36]. Although some positive steps forward have been made, including the National Institute of Health (NIH) initiative in 1993 that all NIH funded clinical trials perform sex-specific analyses [37], these changes are yet to translate into the domain of clinical care in a meaningful way and inform evidence-based change in CVD risk stratification in young females who possess female-specific risk factors for premature CVD.…”

Section: Barriers To Early Diagnosis and Risk Stratification In Womenmentioning

confidence: 99%

Women and Cardiovascular Disease: Pregnancy, the Forgotten Risk Factor

Arnott

Patel

Hyett

et al. 2020

Heart, Lung and Circulation

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Cardiovascular disease (CVD) is the leading cause of death and disability in women globally, accounting for 32% of deaths in females. There are several female-specific risk factors for CVD that are under appreciated clinically, insufficiently researched and not given adequate attention in CVD risk prediction.Hypertensive and metabolic disorders of pregnancy are independent risk factors for the development of premature CVD. They confer more than double the risk of CVD in exposed women, but are not included in any current multivariable CVD risk prediction models.Failure to recognise this risk leads to a lost opportunity to identify at risk women, institute primary preventive strategies, and potentially improve their health trajectory. This also translates into a missed opportunity to educate women and their families about their CVD risks, and to a lack of awareness and prioritisation of CVD within the broader community.Improving CVD outcomes for women globally also requires attention to research methodology and analysis. Researchers should be encouraged to include a thorough pregnancy history in prospective CVD datasets and to power their studies to report on gender disaggregated CVD outcomes. Particular attention should be given to inclusion of young women of child-bearing age in CVD intervention trials.Ultimately, women should be offered CVD assessment using gender specific risk prediction models that are validated across broad ethic and socioeconomic groups. These prediction model should account for female specific risk factors and their complex interactions with traditional risk factors. This will pave the way for a gender-specific approach to CVD diagnosis, investigation and management.

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“…The American Heart Association (AHA) and other health advocacy groups have been trailblazers in the quest to educate, empower, and increase awareness of heart disease in women. As a response to the increasing knowledge of heart disease in women, many women’s heart centers (WHC) have been established [ 2 , 3 ]. While many gains have been attained, much work remains before the gender-related gaps in CV care that currently exist can be eliminated.…”

Section: Introductionmentioning

confidence: 99%