Presentation on theme: "Approaches to Prevention and Recognition of Coronary Artery Disease in Women Tara Conzelman Advisor: Dr. Bob Hadley."— Presentation transcript:
Approaches to Prevention and Recognition of Coronary Artery Disease in Women Tara Conzelman Advisor: Dr. Bob Hadley
Why talk about this now? CAD is the leading cause of death of women in the US Figure 1: CVD and other major causes of death in females, United States 2004. Taken from the AHA Heart disease and stroke statistics - 2007 update.
Why talk about this now? In the past decade, incidence of CAD has doubled among women Research has reported underrecognition and underdiagnosis of CAD in women Practioners can improve survival outcomes by adhering to recommendations shown to benefit women
Background: Differences in CAD in women vs. men CAD incidence lags by ~ 10 yrs. compared to men; MI and sudden death lag by ~20yrs. Chest pain is the most commonly reported symptom in both sexes, but women more frequently report N/V, indigestion, pain in middle of back and jaw High prevalence of nonobstructive CAD and single-vessel disease in women; affects diagnostic accuracy of non-invasive testing
What you need to know What are a woman’s risk factors for developing CAD? What are the current guidelines on CAD prevention for women? What diagnostic tools are useful in risk- stratifying women?
What are a woman’s risk factors for developing CAD? Not modifiable: Age Menopause Heredity
What are a woman’s risk factors for developing CAD? Modifiable: Smoking High blood cholesterol High blood pressure Physical inactivity Obesity & overweight Diabetes Mellitus
What are the current guidelines on CVD prevention for women? New guidelines just published! (March 2007) Changes reflecting recently published studies: Folic acid – now considered a class III intervention (not useful/effective and may be harmful) ASA - should be used in high-risk women unless CI, consider in women ≥65 yoa if no HTN; not recommended in women <65 yoa to prevent MI (class III)
What are the current guidelines on CAD prevention for women?
What diagnostic tools are useful in risk-stratifying women? According to the 2005 “ Role of Noninvasive Testing in the Clinical Evaluation of Women With Suspected Coronary Artery Disease: Consensus Statement From the Cardiac Imaging Committee, Council on Clinical Cardiology, and the Cardiovascular Imaging and Intervention Committee, Council on Cardiovascular Radiology and Intervention, American Heart Association” ….
What diagnostic tools are useful in risk-stratifying women? Cardiac imaging NOT recommended for women @ low pretest risk of CAD (due decreased diagnostic accuracy and higher false-positive rate) Symptomatic intermediate- and high- risk women should initially undergo exercise ECG; (parameters such as exercise capacity and HR changes should be included in evaluation for inc. diagnostic accuracy)
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