Dennis A. Calnon, MD, FACC, FASE, FASNC
Presented at Go Red Luncheon - 01 February 2008
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GRAPHIC SOURCE: Heart Disease and Stroke Statistics-2004 Update, American Heart Association . Women identifying as Black or African-American are more likely to suffer from coronary heart disease or stroke than white women(1). African American women are at highest risk of death from heart disease among all racial, ethnic, and gender groups (1). African American women have higher rates of many risk factors for heart disease, including obesity, physical inactivity, metabolic syndrome, diabetes, and hypertension than white women (1) Among women of various racial and ethnic groups, African American women are less aware that smoking, high cholesterol, and family history increase their risk of cardiovascular disease (2) (1) Heart Disease and Stroke Statistics- 2004 Update, American Heart Association. (2) Mosca L, et al. Tracking womens awareness of heart Disease. Circulation. 2004;109:573-579.
 
GRAPHIC SOURCE: Heart Disease and Stroke Statistics-2004 Update, American Heart Association . Women identifying as Black or African-American are more likely to suffer from coronary heart disease or stroke than white women(1). African American women are at highest risk of death from heart disease among all racial, ethnic, and gender groups (1). African American women have higher rates of many risk factors for heart disease, including obesity, physical inactivity, metabolic syndrome, diabetes, and hypertension than white women (1) Among women of various racial and ethnic groups, African American women are less aware that smoking, high cholesterol, and family history increase their risk of cardiovascular disease (2) (1) Heart Disease and Stroke Statistics- 2004 Update, American Heart Association. (2) Mosca L, et al. Tracking womens awareness of heart Disease. Circulation. 2004;109:573-579.
 
SLIDE INFORMATION SOURCES: Chandra NC, et al. Observations of the treatment of women in the United States with myocardial infarction; a report from the National Registry of Myocardial Infarction-I. Arch Intern Med 1998; 158:981-988; Nohria A, et al. Gender differences in coronary artery disease in women: gender differences in mortality after myocardial infarction: why women fare worse than men. Cardiol Clin 1998; 16:45-57. Scott LB, Allen JK. Providers perceptions of factors affecting womens referral to outpatient cardiac rehabilitation programs: an exploratory study. J Cardiopulm Rehab 2004; 24:387-391. OMeara JG, et al. Ethnic and sex differences in the prevalence, treatment, and control of dyslipidemia among hypertensive adults in the GENOA study. Arch Intern Med 2004; 164:1313-1318. Hendrix KH, et al. Ethnic, gender, and age-related differences in treatment and control of dyslipidemia in hypertensive patients. Ethn Dis 2005; 15:11-16.
SLIDE INFORMATION SOURCES: Mosca L, et al. Evidence-based guidelines for cardiovascular disease prevention in women. Circulation 2004; 109:672-693.; Third Report of the National Cholesterol Education Program (NCEP) Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), NIH, NHLBI, 2002.
SLIDE INFORMATION SOURCES: Mosca L, et al. Evidence-based guidelines for cardiovascular disease prevention in women. Circulation 2004; 109:672-693.; Third Report of the National Cholesterol Education Program (NCEP) Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), NIH, NHLBI, 2002.
SLIDE INFORMATION SOURCE: Stampfer, MJ, et al. Primary prevention of coronary heart disease in women through diet and lifestyle. N Engl J Med 2000; 343:16-22. In a cohort study of 84,129 U.S. female registered nurses (Nurses Health Study), over 40% of coronary events were found to be attributable to smoking. The relative risk of coronary events for nonsmokers compared to smokers is demonstrated on this slide (1). A prospective cohort study in Demark showed a greater relative risk of myocardial infarction for current female smokers (RR=2.24) compared to current male smokers (RR=1.43) (2). (1) Stampfer, MJ, et al. Primary prevention of coronary heart disease in women through diet and lifestyle. N Engl J Med 2000; 343:16-22. (2) Prescott E, et al. Smoking and risk of myocardial infaction in women and men: longitudinal population study. BMJ 1998; 316:1043-1047.
 
SLIDE INFORMATION SOURCES: Mosca L, et al. Evidence-based guidelines for cardiovascular disease prevention in women. Circulation 2004; 109:672-693.; Third Report of the National Cholesterol Education Program (NCEP) Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), NIH, NHLBI, 2002.
SLIDE INFORMATION SOURCE: Mosca L, et al. Evidence-based guidelines for cardiovascular disease prevention in women. Circulation 2004; 109:672-693.;Third Report of the National Cholesterol Education Program (NCEP) Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adults Treatment Panel III), NIH, NHLBI, 2002
SLIDE INFORMATION SOURCES: Mosca L, et al. Evidence-based guidelines for cardiovascular disease prevention in women. Circulation 2004; 109:672-693.; Third Report of the National Cholesterol Education Program (NCEP) Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), NIH, NHLBI, 2002.
SLIDE INFORMATION SOURCE: Mosca L, et al. Evidence-based guidelines for cardiovascular disease prevention in women. Circulation 2004; 109:672-693.
SLIDE INFORMATION SOURCES: Mosca L, et al. Evidence-based guidelines for cardiovascular disease prevention in women. Circulation 2004; 109:672-693.; Third Report of the National Cholesterol Education Program (NCEP) Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), NIH, NHLBI, 2002.
 
SLIDE GRAHIC SOURCE: Centers for Disease Control and Prevention, http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps, accessed on March 12, 2005. America is getting progressively more obese, with highest rates of obesity as shown. Increasing proportions of Americans are either overweight or obese(1). (1) Centers for Disease Control and Prevention, http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps, accessed on March 12, 2005.
SLIDE INFORMATION SOURCE: Manson JE, et al. Body weight and mortality among women. N Engl J Med 1995. 333:677-685. The participants in this part of the Nurses Health Study were 115,195 women free of diagnosed cardiovascular disease and cancer in 1976, who were followed until 1992 (1). This graph demonstrates mortality among non-smoking women at various BMI. The lowest mortality was seen in women who weighed at least 15% less than the U.S. average, and among those whose weight had been stable since early adulthood (1). (1) Manson JE, et al. Body weight and mortality among women. N Engl J Med 1995. 333:677-685.
SLIDE INFORMATION SOURCE: Mosca L, et al. Evidence-based guidelines for cardiovascular disease prevention in women. Circulation 2004; 109:672-693.;Third Report of the National Cholesterol Education Program (NCEP) Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adults Treatment Panel III), NIH, NHLBI, 2002
SLIDE INFORMATION SOURCE: Grundy SM, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation 2005, accessed at www.circulationaha.org on October 25, 2005. The metabolic syndrome is characterized by a constellation of risk factors in one individual. This syndrome increases the risk for CHD at any given LDL-cholesterol level (1). The definition of metabolic syndrome remains controversial. This is the AHA/NHLBI definition. Patients are diagnosed with metabolic syndrome when three of five criteria are met. Patients receiving drug treatment for elevated triglycerides, reduced HDL, hypertension, or high glucose meet the threshhold for each criteria. A cutoff of 31 inches waist circumference for Asian American women should be used(1) (1) Grundy SM, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation 2005, accessed at www.circulationaha.org on October 25, 2005.
SLIDE INFORMATION SOURCES: Mosca L, et al. Evidence-based guidelines for cardiovascular disease prevention in women. Circulation 2004; 109:672-693.; Third Report of the National Cholesterol Education Program (NCEP) Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), NIH, NHLBI, 2002.
SLIDE INFORMATION SOURCE: U.S. Department of Health and Human Services. Physical activity and health: a Report of the Surgeon General. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 1996.
SLIDE INFORMATION SOURCE: Mosca L, et al. Evidence-based guidelines for cardiovascular disease prevention in women. Circulation 2004; 109:672-693.
SLIDE INFORMATION SOURCES: Mosca L, et al. Evidence-based guidelines for cardiovascular disease prevention in women. Circulation 2004; 109:672-693.; Third Report of the National Cholesterol Education Program (NCEP) Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), NIH, NHLBI, 2002.
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