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Women & Heart Disease

Julia C. Orri, Ph.D.Biol. 330

November 21, 2006

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Objectives

List the trends in heart disease for women Name the risk factors for CAD Define atherosclerosis, MI Compare MI signs between men and women Explain gender differences in heart disease Describe strategies to decrease CAD risk in

women

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233,88641,566

67,894

American Heart Association, 2006

Deaths From Breast Cancer, CAD, and lung Cancer (2003)

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Women & CVD

Only 13% of women in America believe that CAD and stroke are the greatest health threats to women.

CDC, 2006

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Women & CVD Facts Nearly 39% of all female deaths occur

from CVD The death rate due to CVD is substantially

higher in African American women than in Caucasian women

38% of women compared to 25% of men will die within 1 year after a heart attack.

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10

15

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25

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35

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Gender?

American Heart Association, 2006

Prevalence of Cardiovascular Diseases in Americans Age 20 and Older by Age and SexNHANES: 1999-2002

11.222.9

36.2

86.4

52.9

68.577.8

6.217.6

36.6

56.5

75.0

0102030405060708090100

20-34 35-44 45-54 55-64 65-74 75+

Ages

Pe

rce

nt

of

Po

pu

lati

on

Males Females

American Heart Association. Heart Disease and Stroke Statistics-2005 Update

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ALOHA to Heart Disease

A- Assess your risk

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Positive Risk Factors for CAD

Family history Hypercholesterolemia Hypertension Cigarette smoking Impaired fasting glucose Obesity Physical inactivity

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Quiz

Holly, 42 years old MI

Runner Non-smoker Non-HT Low cholesterol

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Daily Physical Activity (PA)

Every U.S. adult should accumulate 30 min or moreof moderate-intensity physical activity on most,

preferably all, days of the week.(U.S Surgeon General, CDC, ACSM)

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ALOHA to Heart Disease

A- Assess your risk L- Lifestyle change O- Other interventions H- Highest risk women: highest priority A- Avoid…

Mosca. Circulation, 2004; 109: 158-160

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LDLDIABETES MELLITUSHTSMOKING

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Coronary Artery Disease (CAD)

Normal?

Coronary Artery Disease (CAD)

AtherosclerosisNormal

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CAD (con’t)

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CAD (con’t)

Atherosclerosis Plaque narrows coronary arteries Results in ischemia Leads to myocardial infarction (MI)

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Thrombosis of Coronary Artery

CAD (con’t)

MyocardialInfarction

Myocardial Infarction (MI)

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MI Signs

Severe chest pain/pressure Sweating, nausea, vomiting cardiac enzymes ECG changes

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The Female Heart

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What’s your diagnosis?

Stella, aged 68 Symptoms

Sleep disturbance Unexplained fatigue SOB Indigestion/nausea Pain in back and high chest

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The Female Heart 38.2 million women

have CVD Silent MI more

common Atypical chest pain Delayed diagnosis Underutilized

prevention & research

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Female Heart (con’t)

45 million women older than 50 yr

Smoking cessation rates declining slower than among men

Abdominal obesity 3-7x in CAD risk if

diabetic

More visceralabdominal fat(light) = greaterhealth risk

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Female Heart (con’t)

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Gender

WomenMen

Worse prognosis for women with CAD than men Women had 2x in-hospital mortality rate Age, size of coronary arteries, severity of

sickness at presentation

Fatalityrate

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Take-Home Message Women have worse prognosis and die

more often than men after MI or bypass CAD is largely preventable Major emphasis on lifestyle

modifications: smoking cessation, regular PA, maintenance of healthy weight, lipid lowering therapy

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Thank you!Any questions?

jorri@usfca.edu