1. Women’s Heart Policy October, 2004 Gastein John O’Toole (personal capacity) Perm Rep of Irl to EU

2. CVD largest killer of women in Europe CVD number one killer in Europe, nearly half of all deaths for both sexes, 1 in 3 deaths globally CVD is most common disease in EU CVD is most common killer of women, 55% of all deaths in women are from CVD More women die of CVD than of all cancers combined

3. CVD a neglected killer of women CVD affects women 10 yrs later than men Women less likely to survive MI than men A woman has 50% of dying from first MI, compared with a 30% chance for a man Of those who survive first MI, 38% of women will die within a year, compared to 25% of men Twice as many women as men who have MI will be disabled Stroke kills more women than men, although more men have strokes

4. Women and CVD Reduced mortality but increased morbidity Different risk factors: diabetes, stress, pill Greatest risk factor for women is smoking UK study found that women who drank > 21 units week 70% increased risk of stroke Different treatment regimes, now smaller doses, catheters and stents

5. European Policy Initiatives European Heart Network doing great work, set up informally in 1986, formally in 1992 1996 EHN debated issue of women & CVD at annual congress of ESC Expert Report Euro Heart Health Initiative published February 1997 1998 Euro Heart Health Initiative by EHN 2000 first World Heart Day

6. EU Policy Initiatives Maastricht Treaty 1992 official EU role first time “major health scourges” 1994 Council adopted a resolution on CVD Commission report 1997 found: -gender differences diagnosis & treatment; outcomes & knowledge based on male 2002 Council information point on CVD 2003 Council healthy lifestyles 2004 Year of Education though Sport

7. EU Public Health Programme 2001-2006 Previously fragmented disease-oriented approach with thin spread of resources Now strategic focus on key priorities which are integrated and mutually re-inforcing Emphasis achieving & maintaining better health: information, action & promotion Synergies with other Community policies Exchange of best-practice

8. Irish EU Presidency 2004 Heart Health chosen as the main theme Partnership of Irish Presidency, European Commission, European Heart Network, European Society of Cardiology and WHO in association with US Department of Health & Human Services Expert & Min meetings held in Lux & Cork Council Conclusions agreed heart health

9. Irish Presidency 2004 1996 “Building Healthier Hearts” 211 recs Common & consistent strategies to promote heart health Share experiences, knowledge and approaches Health promotion strategy take account of social, cultural, gender & age differences Health determinants: diet, nutrition, excess alcohol, tobacco control & physical activity

10. Obstacles to EU Action Public perception CVD as a “male” issue Low awareness among women of CVD Women fear cancer, esp. breast cancer CVD risk is 10 times that of breast cancer Absence of an EU legal health base EU Public Health Funding

11. CVD is preventable More gender-specific health policies More gender-specific health information More CVD research on women Appropriate public health interventions NICO Lifestyle changes www.healthysteps.ie www.smokefreeatwork.iewww.healthysteps.ie Promotion & treatment targeted at women Multi-sectoral health promotion approach

12. A major Public Health Challenge Need more ongoing surveillance Need more timely intervention Ageing of the Population High prevalence of primary risk factors (obesity, smoking, sedentary) in women Must involve women in design & delivery Obesity a major cause CVD in future