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W orldwide, cardiovascular disease (CVD) is the largest single cause of death among women, accounting for one third of all deaths. 1 In many countries, including the United States, more women than men die every year of CVD, a fact largely unknown by physicians. 2,3 The public health impact of CVD in women is not related solely to the mortality rate, given that advances in science and medicine allow many women to survive heart disease. For example, in the United States, 38.2 million women (34%) are living with CVD, and the population at risk is even larger. 2 In China, a country with a population of approximately 1.3 billion, the agestandardized prevalence rates of dyslipidemia and hypertension in women 35 to 74 years of age are 53% and 25%, respectively, which underscores the enormity of CVD as a global health issue and the need for prevention of risk factors in the first place. 4 As life expectancy continues to increase and economies become more industrialized, the burden of CVD on women and the global economy will continue to increase. 5 The human toll and economic impact of CVD are difficult to overstate. In the United States alone, $403 billion was estimated to be spent in 2006 on health care or in lost †Representation does not imply endorsement by the American College of Physicians. The online-only Data Supplement is available with this article at http://circ.ahajournals.org/cgi/content/full/CIRCULATIONAHA.107.181546/DC1. The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on January 9, 2007. A single reprint is available by calling 800-242-8721 (US only) or writing the American Heart Association, Public Information, 7272 Greenville Ave, Dallas, TX 75231-4596. Ask for reprint No. 71-0401. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@wolterskluwer.com.This article has been copublished in the March 20, 2007, issue of the Journal of the American College of Cardiology. Expert peer review of AHA Scientific Statements is conducted at the AHA National Center. For more on AHA statements and guidelines development, visit http://www.americanheart.org/presenter.jhtml?identifierϭ3023366.Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American Heart Association. Instructions for obtaining permission are located at http://www.americanheart.org/presenter.jhtml? Identifierϭ4431. A link to the "Permission Request Form" appears on the right side of the page.( Fortunately, most CVD in wome...

RECOMMENDATION 1: In patients with respiratory symptoms, particularly dyspnea, spirometry should be performed to diagnose airflow obstruction. Spirometry should not be used to screen for airflow obstruction in asymptomatic individuals. (Grade: strong recommendation, moderate-quality evidence.) RECOMMENDATION 2: Treatment for stable chronic obstructive pulmonary disease (COPD) should be reserved for patients who have respiratory symptoms and FEV1 less than 60% predicted, as documented by spirometry. (Grade: strong recommendation, moderate-quality evidence.) RECOMMENDATION 3: Clinicians should prescribe 1 of the following maintenance monotherapies for symptomatic patients with COPD and FEV1 less than 60% predicted: long-acting inhaled beta-agonists, long-acting inhaled anticholinergics, or inhaled corticosteroids. (Grade: strong recommendation, high-quality evidence.) RECOMMENDATION 4: Clinicians may consider combination inhaled therapies for symptomatic patients with COPD and FEV1 less than 60% predicted. (Grade: weak recommendation, moderate-quality evidence.) RECOMMENDATION 5: Clinicians should prescribe oxygen therapy in patients with COPD and resting hypoxemia (Pao2 < or =55 mm Hg). (Grade: strong recommendation, moderate-quality evidence.) RECOMMENDATION 6: Clinicians should consider prescribing pulmonary rehabilitation in symptomatic individuals with COPD who have an FEV1 less than 50% predicted. (Grade: weak recommendation, moderate-quality evidence.).

W orldwide, cardiovascular disease (CVD) is the largest single cause of death among women, accounting for one third of all deaths (1). In many countries, including the United States, more women than men die every year of CVD, a fact largely unknown by physicians (2,3). The public health impact of CVD in women is not related solely to the mortality rate, given that advances in science and medicine allow many women to survive heart disease. For example, in the United States, 38.2 million women (34%) are living with CVD, and the population at risk is even larger (2). In China, a country with a population of approximately 1.3 billion, the agestandardized prevalence rates of dyslipidemia and hypertension in women 35 to 74 years of age are 53% and 25%, respectively, which underscores the enormity of CVD as a †Representation does not imply endorsement by the American College of Physicians. Please see the online version of this document for data supplements. The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.