女性心脏病.ppt

Outline The growing burden of heart disease in women Mortality Prevalence-Incidence Outcome Explanations for disparities Action plan Coronary Disease Prevalence NHANES III 1988-94, CDC/NCHS and AHA CHD Incidence Death Within First Month Post-MI Burden of heart disease in women CHD is more prevalent in older women Incidence of all CHD declined among men and younger persons, NOT in women Burden of CHD displaced towards women, who have worst outcomes Why?? Awareness Risk factors “Atypical” symptoms Treatment U.S. women think heart disease is their greatest health threat 51% believe it is cancer Cause of Death in Women Why?? Awareness Risk factors “Atypical” symptoms Treatment Increasing obesity BMI30 Diabetes and CV Risk in Women Reality Greenland et al, JAMA 2003 -Chic. Heart Assoc, MRFIT, Framingham -Before CHD event, exposure to 1 RF in 87-100% of cases Women who actually: Don’t smoke Eat a healthy diet Exercise 30 min/day Are not overweight Use alcohol moderately CV events prevented if ALL women: Did not smoke Ate a healthy diet Exercised 30 min/day BMI 25 Used alcohol moderately Summary The adoption of Western lifestyle and the growing prevalence of risk factors will lead to similar trends in all countries Why?? Awareness Risk factors “Atypical” symptoms Treatment *Women vs men reporting chest pain as a symptom of acute coronary ischemia/infarction Precipitants of Angina Symptoms of Acute CHD in Patients Without Chest Pain Why?? Awareness Risk factors “Atypical” symptoms Treatment Secondary prevention after MIin our practice1821 persons with MI, participation 55% Summary of treatment differences In every circumstance, sex disparities in treatment have been documented Women are less likely to get aggressive treatment than men These disparities identify opportunities for improvement ACTION PLAN 38% CP1021901-10 Women whose doctor discussed heart disease prevention 2003 AHA Survey Mosca, Circulation 2005 *MD’s systematically underestimate CVD