Heart disease and women.
The Red Dress Campaign has caught women's attention regarding the very real dangers of cardiovascular disease, but a new study shows they may not be taking the message to heart.
The study, presented at the re cent annual meeting of the American College of Cardiology, showed that the overall incidence of acute myocardial infarction decreased among 315,246 patients admitted to New Jersey hospitals 1986-2007. The decrease was significant among both men and women, but was more prominent among men.
The incidence of acute MI fell from 598 to 311 per 100,000 men and from 321 to 197 per 100,000 women, according to cardiologist Liliana Cohen and her colleagues at the Robert Wood Johnson Medical School in New Brunswick, N.J. They also identified a growing gap in the rates of left heart catheterization and percutaneous coronary intervention between men and women.
The rates of catheterization increased five-fold in women and three-fold in men over the 22-year study perind, but the likelihood of catheterization remained lower for women. Moreover, the difference among male and female cath patients going on to receive PCI increased from 2.2% in 1986 to 9.4% in 2007.
Finally, both in-hospital and 1-year mortality remained higher among women and failed to significantly decrease after 2002--the year the National Heart, Lung, and Blood Institute launched the Red Dress campaign.
"Although awareness of cardiovascular disease in women has increased in the general population, there has been much less translation of this into clinical practice," according to Dr. Cohen.
This may be due to women presenting later because they doubt an MI can happen to them or due to physicians still not treating women as aggressively as they treat men, she said. It also may relate to the fact that women have more difficult cardiac anatomy, so that even if they receive cardiac catheterization, PCI remains difficult.
Dr. Cohen suggests that the campaign needs to continue to focus on public health awareness but also needs to urge research into ways of translating public awareness into clinical practice by focusing on physicians. Research into newer PCI techniques for the smaller blood vessels in women is also needed.
Quibble if you will about the generalizability of data from a single state or the potential impact of a single PR campaign, but it's hard to ignore these disappointing outcomes.
I once heard a bold and blistering guest lecture at a cancer meeting by Nancy Goodman Brinker, founder and CEO of Susan G. Komen for the Cure, who told several thousand--mostly male--oncologists that a survival rate topping 90% for early stage breast cancer simply wasn't good enough. Truer words were never spoken.
Ms. WENDLING is the Chicago bureau chief for FAMILY PRACTICE NEWS.
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|Publication:||Family Practice News|
|Date:||Jun 1, 2011|
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