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New guidelines announced for preventing heart disease in women
Recommendations should help reduce gender gap’
The American Heart Association (AHA) in Dallas has released new guidelines for preventing heart disease and stroke in women that are tailored to each individual’s cardiac event risk.
In the guidelines, women age 20 and older are treated based on whether they are high, intermediate, or low risk for having a heart attack in the next 10 years (see explanation of risk, below). "The concept of CVD [cardiovascular disease] as a categorical, have-or-have-not’ condition has been replaced with a growing appreciation for the existence of a continuum of CVD risk," according to the AHA panel and writing group.
|CVD risk for women explained|
The American Heart Association guidelines categorize women age 20 and older by their risk of cardiovascular disease (CVD). The risk groups are defined by their absolute probability of having a coronary event in 10 years, according to a scoring method developed by the Framingham Heart Study, which began in 1948 and was sponsored by the National Heart, Lung, and Blood Institute. The risk groups include:
The guidelines, published in the Feb. 10 issue of the journal Circulation, call attention to the leading killer of women, reports C. Noel Bairey Merz, MD, medical director of the Preventive and Rehabilitative Cardiac Center at Cedars-Sinai Medical Center in Los Angeles and associate professor of clinical medicine for the Department of Medicine at the University of California, Los Angeles, School of Medicine. "There has been sufficient amount of new data that were specific to women that we could use to craft more specific recommendations."
The difference now is management, she says. "We’ve known about risk factors since Framingham [Heart Study], which was 50% women. We have always had good risk factor data. What’s new is that we can manage the risk factors better and prevent more disease."
Treatment by risk category
The risk scheme allows health care providers to match the intensity of risk intervention to the baseline level of CVD risk. Here are some of the treatment recommendations for each risk category:
• High risk.
• Intermediate risk.
• Lower risk.
Other notable recommendations
The guidelines also recommended:
Bairey Merz hopes these recommendations will reduce the treatment gender gap between men and women. "Ace inhibitors and beta-blockers were previously recommended, but high-risk women are anywhere from 5% to 20% less likely to be prescribed these pills."
High-risk women should be identified and treated, she continues. "We should not be faced with these gender gaps the next time we look five to 10 years down the line."