Hypertension poses a significant risk to women. An increase in the overall rates of obesity and diabetes have led to more uncontrolled hypertension, which in turn leads to numerous complications which often require revascularization. As it relates to women, after the age of 55, they are at an increased risk for hypertension when compared to men and yet are less likely to receive revascularization. With a growing patient population experiencing hypertension, physicians need to be aware of how to address it appropriately, especially in their female patients.

WIN is putting a focus on this subject matter, conducting a symposia series around hypertension and atrial fibrillation. A lunch program was held during TCT 2011, and another is planned for ESC 2012. The goal is to educate the interventional cardiology community on how to best address uncontrolled hypertension in the female population.

Interestingly, CREATE showed that women were likely to receive aspirin and beta blockers at roughly the same rates as men, but that the more expensive drugs—ACE inhibitors and angiotensin-receptor blockers (ARBs), as well as statins—were used much more commonly in men.

Study investigators suggested that Indian culture might play in these differences. It was speculated that many Indian physicians still work with the impression that heart disease is a man’s disease, and that the level of responsiveness to women with heart disease is low. Additionally, cost of care in India is high, and women are perhaps less likely to voluntarily come out of pocket for their own health.

These and other social and cultural complexities make it difficult to assess health disparities in a way that allows for simple solutions. A layered approach, mixing culturally sensitive physician and patient education, finding new ways of collecting and analyzing data, and pushing the boundaries of innovation will provide a long term solution for women with heart disease.

At a healthcare disparities hearing on Capitol Hill this morning, Dr. Lawrence Tabak, Deputy Director of the National Insitutes of Health (NIH) noted that the NIH is working to diversify its own workforce. He emphasized that diversifying the workforce of any organization is vital to its success, and suggested that as individuals we all carry our own, unrealized biases into our work places. Biased thinking can lead to slowed progress at best and discrimination at worst, and is clearly something to actively try to avoid.

In his talk, Dr. Tabak made mention of a Harvard-based program called Project Implicit. Project Implicit was born out of the theory that people don’t always “know their minds,” and that this lack of understanding can lead to unintended biased decision making.  Visit the site and take the Implicit Association Test to uncover your own biases. You might be surprised at what you find.

• Women undergoing PCI with the unrestricted use of DES differ from their male counterparts and are typically older, have more cardiovascular risk factors except for smoking and a lower degree of angiographic complexity as assessed by the SYNTAX score.
• After controlling for baseline differences, women undergoing PCI with DES have a similar risk of cardiac death and MI as compared with men through two years of follow-up.
• DES achieves equivalent safety and efficacy in women and men with similar results in terms of stent thrombosis, repeat revascularization and angiographic outcomes through two years of follow-up.

“So, have we answered most of the questions with regard to cardiac differences between men and women? Not by a long shot,” wrote editorialist and WIN Member Cindy L. Grines, MD.

WIN plans to host a second gender data forum in September of 2012. This time the focus will be on devices (the first forum, held in December of 2011 was focused on ACS/AMI drug trials). WIN aims to further explore differences in prevalence, mechanism, manifestation and treatment of cardiovascular disease in women.

To view the JACC article, click HERE.

To view additional editorial comments from Cardiovascular Business, click HERE.

In 2010, SCAI WIN helped launch a patient screening program in conjunction with the Abbott Vascular Women’s Heart Health Initiative. The pilot project enrolled sites across the United States, where OBGYN patients were screened for cardiovascular risk factors or disease. From January 2010 to January 2012, 2,234 women (47 percent of whom were postmenopausal) were asked to complete a simple, one-page survey regarding traditional and gestational heart disease risk factors and any current symptoms. Blood pressure readings were taken in all patients with no prior screening. The results from the pilot study were presented yesterday during ACC ’12 by Dr. Jennifer Yu of Mt Sinai University Hospital. WIN hopes to use the momentum of these results to build a PDA app, allowing OBGYN physicians to perform simple but often overlooked cardiovascular disease screenings and increase the referral pathway to cardiologists.

To read the ACC’s press release regarding the study click HERE.

***UPDATE*** The press release on this abstract was picked up by over 30 different publications including Good Morning America Yahoo! News and MSN Health & Fitness

Public health efforts are believed to have contributed to the recent drop in heart disease in Japan, but the country has long been known for having one of the lowest heart disease rates in the world. One study believes it may be due to their fish-heavy diets. Whatever the reason, the Japanese should be looked to as an example for how to lead heart healthy lives.

The interview covers:

• Our current understanding of sex-related differences in CVD.
• How these differences manifest in clinical practice.
• How the perceptions of patients and clinicians can influence management.
• Sex differences in the efficacy of certain cardiovascular interventions.
• How to help ensure that men and women receive appropriate cardiovascular care.

To read the full article and watch the interview video, click on the article link below.

via Sex differences in cardiovascular disease (UPDATED with new data Nov 2011) – Cardiology article – GetInsideHealth.