Women's Health: Getting to the HEART of the Matter José G. Díez, M.D, F.A.C.C., F.S.C.A.I Cardiology Interventional Cardiology, Baylor St. Luke s Medical Center Senior Research Scientist, Texas Heart Institute February 26, 2014
Disclaimers This webinar is a community service and is not intended as a substitute for medical advice. Audience members having questions about their health should contact their personal physician or the Baylor St. Luke s Physician Referral Center: 832-355-4343 or 800-872-9355 Any opinions or statements made during this webinar are those of the presenter and are not the opinions or statements of Baylor St. Luke s Medical Center or The Women s Fund.
Welcome This presentation is designed for anyone interested in learning more about cardiovascular disease (CVD) in women and ways to minimize risk factors Of course, nothing replaces a heart-to-heart talk with your own healthcare professional during your personal medical office visit
In celebration of the American Heart Month, learn about: Your risk factors for cardiovascular disease Prevention strategies Importance of diet in deterring CVD The latest treatment options for women
Addressing the importance of giving enough attention to your Cardiovascular Health.
What Is Cardiovascular Disease? CVD is an umbrella term that describes diseases of the heart and blood vessels (arteries and veins) Some examples of CVD: Coronary artery disease Stroke Heart failure Heart arrhythmias Frequently Asked Questions: Heart Disease. US Department of Health and Human Services, Office on Women s Health. http://www.womenshealth.gov/publications/our-publications/fact-sheet/heartdisease.pdf. Published 2009.
Cardiovascular Disease Is the No. 1 Killer of Women COPD=chronic obstructive pulmonary disease. The Healthy Heart Handbook for Women. National Heart, Lung and Blood Institute. http://www.nhlbi.nih.gov/health/public/heart/other/hhw/hdbk_wmn.pdf. Published March 2007. Based on 2004 data. Leading Causes of Death for Women Heart Disease 332,313 Stroke 91,487 Lung Cancer 67,838 COPD 64,409 Breast Cancer 40,539
In perspective: 1 in 2-3 women will die of heart disease. 1 in 25-31 women will die of breast cancer. AHA Statistics 2013
Cardiovascular Disease in Women The numbers for heart disease: Every woman has a 50% chance of developing heart disease in her lifetime 1 There are 8 million women in the United States living with heart disease 2 That s more than the population of Iowa, Nebraska and Kansas combined! Iowa Nebraska Kansas 1. Roger VL et al. AHA heart disease and stroke statistics 2011 update. Circulation. 2011;123(4):e18 e209. 2. Women and Heart Disease Fact Sheet. Women s Heart Foundation. http://www.womensheart.org/pdfs/factsheet_whd.pdf. Published 2007.
Age-adjusted Death Rates for American Women: U.S. 2006 150.0 130.0 Per 100,000 Population 100.0 101.5 84.5 58.9 57.0 Black/African American White Hispanic Asian 50.0 41.0 39.0 41.3 32.3 34.9 32.2 23.0 18.1 14.1 14.8 11.7 0.0 CHD Stroke Lung Cancer* Breast Cancer* Source: Adapted from American Heart Association 2010 * CDC/National Center for Health Statistics, Health Data Interactive, 2005-2007 10
Prevalence of cardiovascular disease in adults 20 years of age by age and sex (National Health and Nutrition Examination Survey: 2005 2008). Roger V L et al. Circulation 2011;123:e18-e209 Copyright American Heart Association
Heart Attacks in Women Compared to Men The survival gap between men and women continues to widen Both men and women have heart attacks More women than men die from heart attacks Every year: 435,000 women have a heart attack. That s as many people as can fit in 6 NFL football stadiums! 267,000 women die of a heart attack Women and Heart Disease Fact Sheet. Women s Heart Foundation. http://www.womensheart.org/pdfs/factsheet_whd.pdf. Published 2007.
Barriers to Diagnosis More subtle symptoms than those in men 1,2 Low general awareness 3 Communication barriers 1 1. Cantlupe J. Inequities Persist in Women s Cardiovascular Care. http://www.healthleadersmedia.com/page-1/phy- 267750/Inequities-Persist-in-Womens-Cardiovascular-Care. Published June 23, 2011. 2. Roger VL et al. AHA heart disease and stroke statistics 2009 update. Circulation. 2009;119(3):e21 e181. 3. Mosca L et al. Twelve-year follow-up of American women s awareness of cardiovascular disease risk and barriers to heart health. Circ Cardiovasc Qual Outcomes. 2010;3(2):120 127.
Women's Symptoms of Heart Attack Shortness of breath Lightheadedness Cough Heart flutters Chest pain or pressure Discomfort in upper body Loss of appetite Heartburn Cold sweat General tiredness Urge to throw up Women may not experience the characteristic crushing chest pain that men do when having a heart attack Women and Heart Disease Fact Sheet. Women s Heart Foundation. http://www.womensheart.org/pdfs/factsheet_whd.pdf. Published 2007.
Risk Factors for Heart Disease Two types of risk factors increase your chance of developing heart disease Risk factors you can t control such as increasing age Risk factors you can control that are related to your lifestyle
Risk Factors You Can t Control Being postmenopausal Increasing age (older than 55 years) Family history of CVD Ethnicity
Risk Factors You Can Control 1,2 High cholesterol High BP Lack of exercise Being overweight Diabetes Smoking Three or more risk factors = 10 times more likely to develop heart disease BP=blood pressure. 1. Understand Your Risk of Heart Attack. American Heart Association. http://www.heart.org/heartorg/conditions/heartattack/understandyourriskofheartattack/understand-your-risk-of-heart- Attack_UCM_002040_Article.jsp. Published June 20, 2011. 2. Heart Disease Risk Factor Multiplier Effect in Midlife Women. National Heart, Lung and Blood Institute. http://www.nhlbi.nih.gov/educational/hearttruth/downloads/pdf/infographic-multiplier.pdf. Published 2006.
Recommended Screenings to Prevent Cardiovascular Disease Recommended Screening Cholesterol BP Blood sugar Weight/body mass index (BMI) Discuss smoking, physical activity, and diet How Often? Every 5 years for normal-risk people (more often for high risk) At least once every 2 years (if BP is less than 120/80 mm Hg) Every 3 years Each regular healthcare visit Each regular healthcare visit Recommended Screenings/Risk Factors. American Heart Association. http://www.heart.org/idc/groups/heartpublic/@wcm/@hcm/documents/downloadable/ucm_428691.pdf. Published June 2011.
Preventing Cardiovascular Disease: Tips for Healthy Lifestyle Choices Quit smoking or don t start Be more active Eat better Have no more than one drink/day 2011 Heart Disease Prevention Guidelines for Women. American Heart Association. http://www.goredforwomen.org/uploadedfiles/ Heart_Healthy_at_Any_Age_2010/Women's%20Guidelines%20-%201-pager%203-1-2011.pdf. Published 2011.
Learn More on the Web www.mylifecheck.heart.org http://www.nhlbi.nih.gov Toll-free hotline: 1-800-QUITNOW (1-800-784-8669) TTY: 1-800-332-8615 http://www.smokefree.gov
Common Tests and Procedures Blood test Electrocardiogram (EKG or ECG) Exercise stress test Panic Attack or Heart Attack: Diagnosing Heart Disease in Women. Women s Heart Foundation. http://www.womensheart.org/pdfs/hhg-g8-2008.pdf. Published 2000.
Common Tests and Procedures (Cont.) Electron beam computed tomography test Angiography Ultrasound of the heart MRI of the heart Panic Attack or Heart Attack: Diagnosing Heart Disease in Women. Women s Heart Foundation. http://www.womensheart.org/pdfs/hhg-g8-2008.pdf. Published 2000.
Learn More on the Web* For example What Is a Stress Test? American Heart Association Search what is a stress test + heart.org *Terms were searched using Google. Results may vary with other search engines.
Types of Medicines Commonly Used to Treat Cardiovascular Disease Rx Antiplatelets Rx Calcium channel blockers Rx ACE inhibitors Rx Nitroglycerin Rx ARBs Rx Statins Rx Beta blockers ACE=angiotensin-converting enzyme; ARB=angiotensin II receptor blocker. Drugs and Devices. WomenHeart. http://www.womenheart.org/supportforwomen/livinghd/drugsdevices.cfm. Published 2011.
Examples of Surgical Devices to Treat Cardiovascular Disease Coronary artery stent Permanent pacemaker Implantable cardioverterdefibrillator Replacement heart valve Surgical Procedure Guide. WomenHeart. http://www.womenheart.org/supportforwomen/livinghd/procedureguide.cfm. Published 2011.
Cardiac Procedures Used to Treat Coronary Artery Disease: Angioplasty and Stenting The unexpanded stent is delivered to the treatment area via a special catheter The balloon is inflated to expand the stent (stent not shown here to better illustrate the balloon) The balloon is deflated and removed from the body, leaving the stent to hold the artery open What Is Balloon Angioplasty and Stenting? Medtronic, Inc. http://www.medtronic.com/health-consumers/coronary-arterydisease/therapy/ balloon-angioplasty-and-stenting/what-is-stent-and-balloon-therapy/index.htm. Published September 22, 2010.
Aortic Valve Normal vs. Abnormal Function (Stenosis/Narrowing)
Photographs of transcatheter aortic valves. Webb J, Cribier A Eur Heart J 2011;32:140-147
Percutaneous aortic valve implantation. Webb J, Cribier A Eur Heart J 2011;32:140-147
The Key to Living Well with Heart Disease Understand heart disease and educate yourself Manage your lifestyle Minimize your risk factors Know your numbers Stay positive! Living Well with Heart Disease. WomenHeart. http://www.womenheart.org/supportforwomen/livinghd/livingwell.cfm. Published 2011.
Your Heart Health Team Cardiologist Pulmonologist Nutritionist Primary care physician You Social worker/ psychologist Nurse practitioner/ cardiac rehab nurse Cardiac or other surgeon Living Well with Heart Disease. WomenHeart. http://www.womenheart.org/supportforwomen/livinghd/livingwell.cfm. Published 2011.
Where Can You Find More Information? http://www.womenheart.org http://www.pcna.net/women.php American Heart Association Go Red for Women http://www.goredforwomen.org http://www.womenshealth.gov http://www.nhlbi.nih.gov
Thank you for your attention JOSE G. DIEZ, MD, FACC, FSCAI