Simple screening implemented in obstetrics and gynecology (OB/GYN) clinics may identify previously undetected heart disease risk among women and has the potential to greatly increase education about prevention and treatment of cardiovascular disease in female patients, according to research presented today at the American College of Cardiology's 61st Annual Scientific Session. The Scientific Session, the premier cardiovascular medical meeting, brings cardiovascular professionals together to further advances in the field.
Heart disease is the leading cause of death among women in the United States, and the rate of heart disease deaths in women aged 35 to 44 continues to increase by approximately 1 percent each year. Currently, many women are undertreated or remain unaware of their heart disease risk factors.
"There is a real disparity in the medical community where we tend to think heart disease is a disease of men, and historically we have not done a very good job of screening women for cardiovascular risk factors," said Roxana Mehran, MD, director of interventional cardiovascular research and clinical trials, Mount Sinai Medical Center, and the study's principal investigator. "It often doesn't occur to women that they could have a heart problem until their symptoms are very advanced, so we have to think differently and be creative about how we identify, educate and treat women at risk."
Researchers implemented a pilot program at 10 OB/GYN clinics to screen women 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.
Cardiovascular risk factors and symptoms were common (69 percent and 42 percent, respectively) among middle-aged women screened in the pilot, suggesting that cardiovascular assessment in the setting of OB/GYN clinics may enhance the delivery of primary prevention and education to female patients.
Of the women screened, 18 percent considered their OB/GYN as their primary health care provider. A significant proportion of screened patients either did not know or had never had testing of their blood pressure, cholesterol or blood sugar levels (21, 38, and 19 percent respectively). After the screening process, 25 percent of patients were referred to another health provider (primary care physician, cardiologist, endocrinologist, or other) for further evaluation and treatment of heart disease risk factors.
"We found a real lack of awareness among many of these women that they had risk factors, including diabetes, high blood pressure and high cholesterol. OB/GYN practices have an incredible opportunity to make an impact on heart disease in women by screening, educating and directing women to the right providers, so we hope to see continued research in this area," Dr. Mehran said.
In particular, she said future trials should involve a larger patient pool in order to demonstrate an improvement of clinical outcomes in women with cardiovascular disease.
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