Early identification and treatment of women's cardiovascular risk factors prevents cardiovascular disease, saves lives, and protects future generations: Policy recommendations and take action plan utilizing policy levers

Abstract

Cardiovascular diseases (CVD) including heart attacks, strokes, heart failure, and uncontrolled hypertension are leading causes of death among women of all ages. Despite efforts to increase awareness about CVD among women, over the past decade there has been stagnation in the reduction of CVD in women, and CVD among younger women and women of color has in fact increased. We recommend taking action using policy levers to address CVD in women including: (1) Promoting periodic screening for risk factors including blood pressure, lipids/cholesterol, diabetes for all women starting at 18–21 years, with calculated atherosclerotic CVD (ASCVD) risk score use among women 40 years or older. (2) Considering coronary artery calcium (CAC) screening for those with intermediate risk per current guidelines. (3) Enhancing Obstetrics and Gynecology and primary care physician education on reproductive age CVD risk markers, and that follow‐up is needed, including extended postpartum follow‐up. (4) Offering Health Coaching/motivational Interviewing to support behavior change. (5) Funding demonstration projects using different care models. (6) Creating a Stop High Blood Pressure consult line (for providers and patients) and providing other support resources with actions consumers can take, modeled after the California tobacco quit line. And (7) Requiring inclusion of adverse pregnancy outcomes in all Electronic Health Records, with reminder systems to follow‐up on hypertension post‐partum.

Cardiovascular prevention in women: an update by the Italian Society of Cardiology working group on ‘Prevention, hypertension and peripheral disease’

“…Healthy lifestyle and adherence to guideline-based care can effectively prevent CVD 5,6 . However, several known factors widen gender disparities in the prevention of CVD: adoption of unhealthy lifestyles by women, underestimation of female risk categorization and the inability to identify early and treat properly CVD in women 7 . Women tend to have a longer life expectancy; however, while living longer, they generally have worse health status and higher rates of chronic diseases than men 8 .…”

“…5,6 However, several known factors widen gender disparities in the prevention of CVD: adoption of unhealthy lifestyles by women, underestimation of female risk categorization and the inability to identify early and treat properly CVD in women. 7 Women tend to have a longer life expectancy; however, while living longer, they generally have worse health status and higher rates of chronic diseases than men. 8 As nutrition is directly related to a higher risk of developing chronic disease, it is essential to understand how this modifiable factor affects health status.…”

Cardiac damage following renal ischemia reperfusion injury increased with excessive consumption of high fat diet but enhanced the cardiac resistance to reperfusion stress in rat

“…Even though the mortality rate of kidney transplant recipients is considerably reduced, the proportion of cardiovascular-related deaths remains the major known reason for death in transplant patients [ 42 , 43 ]. Identifying, treating, and preventing the risk factors may decrease mortality, as per the observations made by many clinicians [ 44 ].…”

Implementation and Reach of Health Coaching Using Motivational Interviewing to Reduce Cardiovascular Disease Risk in Uninsured Illinois Women

“…3 Despite women's risk for high BP increasing after menopause, CVD can negatively affect women of all ages. 4 Socioeconomic factors such as lack of insurance are heavily associated with CVD risk as they are linked to lack of access to preventative care and increased mortality. 5 Further, in addition to CVD posing a mortality threat to women, it can also be a significant financial burden that can leave a multitude of negative impacts on the individual, especially uninsured women.…”

“…While some precursor characteristics such as blood pressure (BP) tend to be higher in men during the reproductive years, once women enter menopause they show a sharp increase in BP resulting in a greater incidence of CVD in older women than men 3. Despite women’s risk for high BP increasing after menopause, CVD can negatively affect women of all ages 4…”