Ten points. With a guide to improving the prevention and treatment of cardiovascular disease in women, the leading cause of death in women. To propose them is the first global report on cardiovascular diseases in women, produced by an international commission of 17 experts from 11 countries, published on The Lancet and presented at the conference ofAmerican College of Cardiology. The document (The Lancet Women and Cardiovascular Disease Commission: reduce the global burden by 2030) indicates the importance of reducing the global impact of cardiovascular diseases – in particular heart attack, heart failure and stroke – by 2030. Experts have outlined 10 recommendations ambitious to address inequalities in diagnosis, treatment and prevention to reduce cardiovascular disease in women, such as educating health professionals and patients on early detection of female heart disease, increasing heart health programs in women highly populated and underdeveloped regions, a call to gender research with priority on sex-specific research on heart disease in women and intervention strategies.
After a heart attack, women are more at risk than men
Second Roxana Mehran, of Mount Sinai Medical Center “Cardiovascular disease in women remains underestimated, underdiagnosed and under-treated globally. Achieving the important goal set by the United Nations requires bold and distinct strategies not only to target the factors that contribute to cardiovascular disease, but also to identify the specific biological mechanisms of sex in women. Making permanent improvements to care around the world for women with these conditions requires coordinated efforts and partnerships involving policy makers, doctors, researchers and the wider community. ”
The numbers worry
The document shows the data of the Global Burden of Disease Study of 2019. Immediately before Covid-19 there were about 275 million women with cardiovascular diseases in the world, about 6,402 cases out of 100,000. The leading cause of death worldwide in 2019 was ischemic heart disease (47% of deaths from cardiovascular causes), followed bystroke (36% of deaths). The highest prevalence in Egypt, Iran, Iraq, Libya, Morocco and the United Arab Emirates, the lowest in Bolivia, Peru, Colombia, Ecuador and Venezuela.
Heart door
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at Federico Mereta
Although globally the prevalence of cardiovascular disease in women has decreased overall by 4.3% since 1990, some of the most populous nations in the world have instead gone against the trend: among them China (10% increase), Indonesia (7% ), and India (3%). These increases indicate the need for initiatives to expand the prevention, diagnosis and treatment of these diseases in women living in highly populated and industrializing regions. The highest mortality rates are recorded in Central Asia, Eastern Europe, North Africa and the Middle East, Oceania and Central Sub-Saharan Africa, where age-standardized mortality exceeds 300 deaths per 100,000 women.
Heart Door
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at Federico Mereta
Act on risk factors
L’hypertension is the biggest risk factor contributing to years of life lost from cardiovascular disease in women, followed by a high body mass index linked to overweight and obesity and yes high Ldl cholesterol values. These elements have a different impact on women than on men. Then, there are sex-specific risk factors such as premature menopause e i disorders related to pregnancy which need to be more widely recognized and prioritized as part of treatment and prevention efforts around the world.
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“The report by Lancet – explains Daniela Trabattoni, head of Monzino Women, a project dedicated to women’s hearts at the Monzino Irccs Cardiology Center in Milan – highlights how cardiovascular pathologies represent the leading cause of death in women. For years it was believed that women’s hearts were protected by female hormones, but the data showed us the opposite: cardiovascular diseases cause over 43% of female deaths compared to 33% of male ones. All lives that can be saved with effective and gendered prevention “.
Women, that’s why they forget about a heart attack
For women, in fact, special attention is essential. In addition to the main risk factors now known to all (we repeat: hypertension, overweight / obesity and high LDL cholesterol values) there are other sex-specific elements. “Premature menopause, premature birth, spontaneous abortion, depression, anxiety – he continues – can increase female cardiovascular risk. Other elements, such as socio-economic and poverty status and cultural level, can negatively affect cardiovascular prevention. objective proposed by the International Commission of Lancet for cardiovascular diseases in women, it is possible to reduce the incidence of heart disease from stroke by 30% worldwide by 2030. To achieve this, everyone’s commitment is needed. At Monzino we started studying and identifying women’s specific risk factors and building targeted screening programs. In the first three years of Monzino Women’s activity, we followed 585 women without obvious symptoms or previous cardiovascular events and with an average age of 52 years: in 25% of cases, screening revealed a medium-high risk profile, such as to make it necessary a lifestyle correction or therapy, for example to lower cholesterol, normalize blood pressure, or reduce homocysteine, a protein that indicates the development of atherosclerotic disease. The tests our patients have undergone are simple and non-invasive, first-level investigations, as well as electrocardiograms and blood sampling. We are very satisfied with the results obtained and the progressive increase in access, and we have new interesting projects to continue along this path ”.
A focus on information and smoke
From the report of Lancet, in addition to the classic physical risk factors, it should be noted how unemployment, anxiety and depression as well as inequalities based on socio-economic and cultural status, ethnicity and poverty can impact on female cardiovascular well-being. Therefore, greater attention to mental health in clinical practice and targeted policy work to support populations of low socioeconomic status in developed and emerging countries is recommended.
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It also appears fundamental to increase awareness of cardiovascular risk in women among doctors, scientists and health professionals and that there is an unmet need for models for predicting these pathological conditions that include sex-specific risk factors. In this sense it is important to reach groups not generally considered to be at high risk, such as young women, a group in which heart attacks and smoking rates are on the rise. In the last decade, 53 out of 195 countries (27%) recorded significant reductions in the prevalence of smoking among men, while only 32 (16%) for women.
Smoking is more dangerous for a woman’s heart than for a man
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