Women and Cardiovascular Disease: Pregnancy, the Forgotten Risk Factor

Arnott, Clare; Patel, Sanjay; Hyett, Jon; Jennings, Garry; Woodward, Mark; Celermajer, David S.

doi:10.1016/j.hlc.2019.09.011

Cited by 22 publications

(17 citation statements)

References 58 publications

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“…In our study, STEMI care was comparable between men and women and across all age groups, with comparable rates of catheterization and door‐to‐balloon times. Thus, a systems‐based approach should be multifaceted to reduce sex‐based disparities; by protocolizing STEMI care, targeting comorbid disease with sex‐specific, evidence‐based approaches among men and women across age groups, and educating the public to decrease delays in seeking medical attention 39‐42 …”

Section: Discussionmentioning

confidence: 99%

Outcomes of ST‐elevation myocardial infarction by age and sex in a low‐income urban community: The Montefiore STEMI Registry

Bortnick

Shahid

Shitole

et al. 2020

Clinical Cardiology

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Objectives: To compare outcomes by age and sex in race/ethnic minorities presenting with ST-elevation myocardial infarction (STEMI), as studies are limited. Methods: We studied sociodemographics, management, and outcomes in 1208 STEMI patients evaluated for primary percutaneous coronary intervention between 2008 and 2014 at Montefiore Health System (Bronx, NY). A majority of patients self-identified as nonwhite, and nearly two-thirds were young (<45 years) or middle-aged (45-64 years). Results: Risk factors varied significantly across age groups; with more women and non-Hispanic whites, hypertension, diabetes, dyslipidemia, prior cardiovascular disease, non-sinus rhythm, and collagen vascular disease in the older age group (≥65 years); and higher body mass index, smoking, cocaine use, human immunodeficiency virus (HIV) infection and family history of heart disease in the young. Younger women had lower summary socioeconomic scores than younger men. Middle-aged women had more obesity and dysmetabolism, while men had more heavy alcohol use. There was greater disease severity with increasing age; with higher cardiac biomarkers, 3-vessel disease, cardiogenic shock, and coronary artery bypass grafting. Older patients had higher rates of death and death or readmission over 4.3 (interquartile range 2.4, 6.0) years of follow-up. Middle-aged women had higher rates of death or any readmission than men, but these differences were not significant after adjustment.

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Section: Discussionmentioning

confidence: 99%

Outcomes of ST‐elevation myocardial infarction by age and sex in a low‐income urban community: The Montefiore STEMI Registry

Bortnick

Shahid

Shitole

et al. 2020

Clinical Cardiology

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“…In turn, this misunderstanding is generated by the differences in the clinical presentation of CVD in the two sexes and by the increased prevalence of CVD in women of advanced postmenopausal age [ 8 , 9 ]. Moreover, several female-specific risk factors for CVD, such as polycystic ovary syndrome, premature ovarian failure, hypertensive disorders of pregnancy, gestational diabetes, and preterm birth, are underappreciated clinically and not receive adequate attention in CVD risk prediction [ 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Risk Perception and Knowledge among Italian Women: Lessons from IGENDA Protocol

Maffei

Meloni

Deidda

et al. 2022

JCM

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A multicenter, cross-sectional observational study (Italian GENder Differences in Awareness of Cardiovascular risk, IGENDA study) was carried out to evaluate the perception and knowledge of cardiovascular risk among Italian women. An anonymous questionnaire was completed by 4454 women (44.3 ± 14.1 years). The 70% of respondents correctly identified cardiovascular disease (CVD) as the leading cause of death. More than half of respondents quoted cancer as the greatest current and future health problem of women of same age. Sixty percent of interviewed women considered CVD as an almost exclusively male condition. Although respondents showed a good knowledge of the major cardiovascular risk factors, the presence of cardiovascular risk factors was not associated with higher odds of identifying CVD as the biggest cause of death. Less than 10% of respondents perceived themselves as being at high CVD risk, and the increased CVD risk perception was associated with ageing, higher frequency of cardiovascular risk factors and disease, and a poorer self-rated health status. The findings of this study highlight the low perception of cardiovascular risk in Italian women and suggest an urgent need to enhance knowledge and perception of CVD risk in women as a real health problem and not just as a as a life-threatening threat.

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“…The currently available cardiovascular risk scores have been developed using acute coronary syndrome thresholds found in predominantly male populations, reducing their reliability for use in women ( 20 ). The vast majority also fail to consider early changes in cardiovascular measures as well as the young age of the study population, which conceals the high-risk, long-term impact of a complication of pregnancy ( 21 ). The Absolute Cardiovascular Disease Risk Calculator, for example, is commonly used by general practitioners in Australia for calculating cardiovascular risk in adults, and is recommended by the Australian Heart Foundation.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Metabolic Syndrome in Women After Maternal Complications of Pregnancy: An Observational Cohort Analysis

Aldridge

Pathirana

Wittwer

et al. 2022

Front. Cardiovasc. Med.

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IntroductionCertain complications of pregnancy, including hypertensive disorders of pregnancy, gestational diabetes mellitus, intrauterine growth restriction, spontaneous preterm birth, and placental abruption, are established independent risk factors for premature cardiovascular disease in women. Metabolic syndrome, which is associated with an increased risk of cardiovascular disease, may be a suitable alternative to traditional cardiovascular risk calculators that underestimate risk in young women. This study aimed to investigate the prevalence of metabolic syndrome in women who experienced a complicated pregnancy 6 months earlier.MethodsThis observational study investigated the prevalence of metabolic syndrome as defined by the International Diabetes Federation in all eligible participants (n = 247) attending a postpartum lifestyle intervention clinic from August 2018 to June 2021 at the Lyell McEwin Hospital in Adelaide, South Australia.ResultsA total of 89 (36%) participants met the criteria for metabolic syndrome at a mean follow up time of 7 months postpartum. Almost 90% of the cohort were abdominally obese, and over two thirds of the total cohort met at least two of the criteria for metabolic syndrome.ConclusionsWomen with a prior history of one of the common major pregnancy complications are at high risk of future cardiovascular and metabolic disease, with many showing either metabolic syndrome or multiple risk factors at only 7 months postpartum. The results indicate that follow-up within 1 year postpartum is an appropriate time to commence preventative strategies, as many women are already showing early signs of disease.

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Women and Cardiovascular Disease: Pregnancy, the Forgotten Risk Factor

Cited by 22 publications

References 58 publications

Outcomes of ST‐elevation myocardial infarction by age and sex in a low‐income urban community: The Montefiore STEMI Registry

Outcomes of ST‐elevation myocardial infarction by age and sex in a low‐income urban community: The Montefiore STEMI Registry

Cardiovascular Risk Perception and Knowledge among Italian Women: Lessons from IGENDA Protocol

Prevalence of Metabolic Syndrome in Women After Maternal Complications of Pregnancy: An Observational Cohort Analysis

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