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Predictive risk factors by gender will help diagnose and treat CVD in women

Prevention


If gender differences in cardiovascular disease risk factors and effective treatment methods are to be better understood, more women need to be included in targeted clinical trials and health care professionals must better understand the role age plays in women’s risk of heart disease, according to the results of an ESC Policy Conference on CVD in Women.

Fifty-five percent of European women die from CVD each year, yet many members of the medical community are unaware that the risk factors for women are different than for men or that treatment should vary according to gender.

“The risk of heart disease in women is underestimated because of the perception that women are ‘protected’ against ischemic heart disease. What is not fully understood is that women during the fertile age have a lower risk of cardiac events, but this protection fades after menopause thus leaving women with untreated risk factors vulnerable to develop myocardial infarction, heart failure and sudden cardiac death, said Marco Stramba-Badiale, chairperson of the Policy Conference and a member of the ESC’s Woman at Heart committee.

The Policy Conference results were discussed at the European Society of Cardiology/European Heart Network March 7 conference about women’s heart health, held in Brussels. A full report will be published the same day on the European Heart Journal website. (1)

The Policy Conference concludes that predictive value by gender should be encouraged and the higher mortality rate in women with acute coronary syndromes should be taken into account in clinical management. Additionally, because age plays such a significant role in women’s CVD, it should be given more consideration during diagnosis and treatment planning. Physicians should be urged to remember that a woman at low absolute may carry a high relative risk because of the age factor.

The report of the Policy Conference also notes that despite the higher risk of stroke, women with atrial fibrillation prior to having an acute stroke do not receive adequate antithrombotic therapy. Women are under-treated with acute thrombolysis mostly because of greater delay in hospital arrival after the onset of symptoms.

The Policy Conference proposed some immediate actions that should be undertaken with the hope that synergic activities will be implemented at European level with the support of national health care authorities, which was discussed at the March 7 conference.

“Cardiovascular disease is the leading cause of death in Europe and as such there is an overwhelming need to approach the problem in a multidisciplinary manner that highlights the importance of disease prevention and gender differences,” said Michal Tendera, ESC president. “A unified approach by the EUs health care community will help bring attention to the parameters associated with CV health and will help provide understanding about prevention measures."

The ESC is working on several initiatives to help promote prevention measures. Women at Heart, launched in March 2005, highlights to medical professionals the growing burden and under-appreciation of women's heart disease. Through Women at Heart, the ESC is working towards an increased awareness across Europe that CVD is the primary cause of death in women; a better understanding of women's risk factors and presentation profiles by the medical profession; improved treatment of women with CVD by the medical profession and an increased representation of women in clinical trials.

The European Society of Cardiology (ESC)

The ESC represents more than 45,000 cardiology professionals across Europe and the Mediterranean. Its mission is to improve the quality of life of the European population by reducing the impact of cardiovascular disease. The ESC achieves this through a variety of scientific and educational activities including the coordination of: clinical practice guidelines, education courses and initiatives, pan-European surveys on specific disease areas and the ESC Annual Congress, the largest medical meeting in Europe. The ESC Congress 2006, to be held from 2-6 September in Barcelona, Spain, will be a joint meeting with the World Heart Federation's XVth World Congress of Cardiology.

References

(1) Cardiovascular diseases in women: a statement from the policy conference of the European Society of Cardiology, Stramba-Badiale M, Fox KM, Priori SG, Collins P, Daly C, Graham I, Jonsson B, Schenck-Gustafsson K, Tendera M. doi:10.1093/eurheartj/ehi819.

Notes to editor

The European Heart Journal is an official journal of the European Society of Cardiology. Please acknowledge the journal as a source in any articles.