American Heart Association Guidelines for heart disease prevention in women were released today to reflect what committee members say works in real life, rather than recommendations based on research findings alone.
Highlighted in the report are three key elements of prevention focus that include:
- Personal and socioeconomic factors that can interfere with women following medical advice for heart disease prevention
- Consideration of other diseases such a lupus, rheumatoid arthritis and pregnancy complications that increase a woman’s likelihood of heart disease
- Practical understanding of steps that can be taken to reduce risk factors of heart disease and stroke
The updated guidelines are a variance from the original 1999 heart disease prevention in women guidelines that were based primarily on research findings.
Lori Mosca, M.D., M.P.H., Ph.D., chair of the guidelines writing committee and a medical advisor for the American Heart Association’s Go Red For Women movement explains, “Many women seen in provider practices are older, sicker, and experience more side effects than patients in research studies. Factors such as poverty, low literacy level, psychiatric illness, poor English skills, and vision and hearing problems can also challenge clinicians trying to improve their patients’ cardiovascular health.”
She says the new recommendations underscore that what is seen day to day in doctor’s offices as necessary for preventing women’s heart disease differs from clinical research, and outlines strategies that start with open dialogue between women and their physicians.
“If the doctor doesn’t ask the woman if she’s taking her medicine regularly, if she’s having any side effects or if she’s following recommended lifestyle behaviors, the problems may remain undetected,” Dr. Mosca said. “Improving adherence to preventive medications and lifestyle behaviors is one of the best strategies we have to lower the burden of heart disease in women.”
Other efforts and initiatives to raise awareness of women’s heart disease include Get With The Guidelines® and Go Red for Women.
Another example is consideration a woman’s history of preeclampsia that doubles the risk of heart disease and stroke 5 to 15 years after delivery and raises the chances of dangerous blood clots. Mosca says the risk for women can be considered the same as failing a stress test.
Autoimmune diseases like lupus and rheumatoid arthritis should also not be ignored and are important for women and their physicians when making decisions about preventive treatments needed for heart disease, conditions that Mosca says, …”have not traditionally been top of mind as risk factors for heart disease.”
Depression screening is also recommended. Depressed women may have trouble adhering to medicine regimens and following doctor’s advice.
The updated guidelines also include recognizing racial and ethnic heart disease risk factors. Diabetes and hypertension are more prevalent in African American and Hispanic women. Some of the current therapies in the guidelines are not shown by clinical evidence to help women, and may actually cause harm Mosca says.
Puberty, menopause and pregnancy are important times for assessing heart disease risk in women. Overall prevention is now known to be similar for women and men.
“These guidelines are a critical weapon in the war against heart disease, the leading killer of women,” Mosca said. “They are an important evolution in our understanding of women and heart disease. And I cannot stress personal awareness and education enough. Initiatives such as Go Red For Women give women access to the latest information and real-life solutions to lower their risk of heart disease.”
The 2011 guidelines for heart disease prevention in women are similar to men, but reflect updates that work in the “real world”. The new guidelines take into consideration personal and socioeconomic factors that can prevent women from following physician advice for heart disease and stroke prevention and are based less on clinical research and are more realistic than those introduced in 1999.
American Heart Association