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Cardiovascular diseases in women

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Cardiovascular diseases in women Fast facts

• Cardiovascular disease (CVD) is the primary cause of death in European women

• It kills a higher percentage of women (55%) even than men (43%) and more than all cancers combined.

• However, there still exists a disturbing gap in the knowledge, understanding, and general awareness of cardiovascular disease in women, across medical audiences as a whole.

• Cardiovascular disease (CVD) is the primary cause of death in European women

• It kills a higher percentage of women (55%) even than men (43%) and more than all cancers combined.

• However, there still exists a disturbing gap in the knowledge, understanding, and general awareness of cardiovascular disease in women, across medical audiences as a whole.

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The impact of underestimation

• As a frightening consequence of the underestimation of cardiovascular diseases in women, risk factors for heart disease are raising among women

• As a frightening consequence of the underestimation of cardiovascular diseases in women, risk factors for heart disease are raising among women

> Specific campaigns on prevention of cardiovascular diseases in women are needed

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The heart of men and women

• Clinical and epidemiological studies have shown that men and women with cardiovascular disease differ with respect to disease processes, clinical presentations, and outcomes.

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What is different in CVD in Women?

• Women develop heart disease later in life than men;

• Women are more likely to have co-morbidities that may mask symptoms of heart disease;

• Symptoms of a heart attack in women may differ from those in men, leading to a misdiagnosis of the disease;

• Post MI women who are more likely to have a stroke or another heart attack than men;

• 42% of women die within one year following a heart attack vs. 24% of men.

• Women develop heart disease later in life than men;

• Women are more likely to have co-morbidities that may mask symptoms of heart disease;

• Symptoms of a heart attack in women may differ from those in men, leading to a misdiagnosis of the disease;

• Post MI women who are more likely to have a stroke or another heart attack than men;

• 42% of women die within one year following a heart attack vs. 24% of men.

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The impact of CVD in Women

As compared to men, women have a poorer prognosisand experience greater disability moreover they:

• Are at a higher risk of psychosocial distress; • Have a greater need for instrumental support and

social support;• Have an altered perception of risk;• Demonstrate the need for specific rehabilitation

programs, tailored to their needs.

Davidson et al 2001

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Do we have data to cure the heart of women?

The enrolment of women in clinical trials cameunder scrutiny in the mid-1980s with therealisation that less information about treatmentwas available for women with cardiovasculardisease than for men with the disease.

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Gender specific differences in the effects of treatment

To determine definitively whether anintervention or therapy affects women and mendifferently, the trial must include a number ofwomen to ensure that the study has thestatistical power to evaluate the effect of theintervention in each sex and to compare themagnitude of these effects.

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Moving in the right direction

In 1993 the NIH Revitalization Act required the

inclusion of women in every clinical trial involving

a disorder that affects women to:

“….ensure that the trial is designed and carried out in a manner sufficient to provide for a valid analysis of whether the variables being studied in the trial affect women [and men] differently."

In 1993 the NIH Revitalization Act required the

inclusion of women in every clinical trial involving

a disorder that affects women to:

“….ensure that the trial is designed and carried out in a manner sufficient to provide for a valid analysis of whether the variables being studied in the trial affect women [and men] differently."

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Conclusion

• Cardiovascular diseases are a major cause of morbidity and mortality female patients;

• The pivotal role of CVD in women is under recognized by citizens and physicians alike;

• The distinguishing aspects of CVD in women are not familiar to medical professionals.

• Cardiovascular diseases are a major cause of morbidity and mortality female patients;

• The pivotal role of CVD in women is under recognized by citizens and physicians alike;

• The distinguishing aspects of CVD in women are not familiar to medical professionals.

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A need for action

• Need for a fair gender representation in clinical trials;

• Promote research both at clinical and basic level to understand more on CV Physiology in females;

• Assess if gender specific differences exist in the response to therapy.

• Need for a fair gender representation in clinical trials;

• Promote research both at clinical and basic level to understand more on CV Physiology in females;

• Assess if gender specific differences exist in the response to therapy.

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Objectives

Three main goals need to be achieved to impact

CVD in women:

• Education of the Profession

• Education of the Patients

• Collection of epidemiological and outcome data

Three main goals need to be achieved to impact

CVD in women:

• Education of the Profession

• Education of the Patients

• Collection of epidemiological and outcome data

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The ESC effort to fill the gap

• The European Society of Cardiology is committed to provide education and research on the topic of CVD in women and has therefore organized a targeted initiative.

• Women at Heart, the ESC program on CVD in women will act in synergy with existing initiatives that are taking place in Europe and in the USA

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Committed to Improving Heart Health for Women

An initiative of the

European Society of Cardiology

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1. Primary target audience = Medical Profession2. Focus on the scientific underpinning of the

topic3. ESC strive to provide evidence based

information for various stakeholders 4. Not a PR campaign

Women at HeartDistinguishing profile of the ESC initiative

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Women at Heart Policy Conference on CVD in Women

• Meeting of more than 62 experts and representatives of National Societies, Working Groups and Associations

• Production of a scientific and political statement on the topic, to be published in the European Heart Journal

23-24 June 2005,

European Heart House

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Women at HeartEuropean Data on CVD in Women

Analysis from the EuroHeart Survey databasesOn epidemiology of CVD in women and women’s access to treatment

> Preparation of a comprehensive summary of results/ original educational material

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Women at Heart ESC Congress 2005

• Special focus on women and CVD, in the mainsessions, through dedicated sessions, oral abstracts and posters presentations

• Specific information on risk factor reduction through lifestyle improvements, at theESC public event, ‘For Your Heart’s Sake, 2-4 September 2005, Stockholm, Sweden.

3-7 September 2005 Stockholm, Sweden

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Women at HeartNext Steps

• Through the ESC network of 49 affiliated countries, National Cardiac Societies are taking up the challenge and adapting the initiative at a national level.

• Increased awareness of women’s CVD patterns • Improved quality of care of women with heart disease and stroke across Europe.

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Show your support, Wear the symbol!

womenatheart@escardio.org