Eliminating untimely deaths of women from heart disease: Highlights from the Minnesota Women's Heart Summit

Lindquist, Ruth; Boucher, Jackie L.; Grey, Elizabeth; Cairns, Beth; Bobra, Shalini; Windenburg, Denise; Konety, Suma; Graham, Kevin J.; Luepker, Russell V.; Hayes, Sharonne N.

doi:10.1016/j.ahj.2011.09.020

Cited by 12 publications

(7 citation statements)

References 49 publications

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“…in CKD would be timely, because the interplay between sex-specific biology and perception is in the interest of patients and has been addressed more rigorously for other chronic conditions, such as cardiovascular disease (29)(30)(31).…”

Section: Discussionmentioning

confidence: 99%

Sex Differences in Kidney Replacement Therapy Initiation and Maintenance

Antlanger

Noordzij

Luijtgaarden

et al. 2019

CJASN

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Background and objectives More men than women undergo kidney replacement therapy (KRT) despite a larger number of women being affected by CKD. The aim of this multinational European study was to explore whether there might be historic and geographic trends in sex-specific incidence and prevalence of various KRT modalities. Design, setting, participants, & measurements We assessed sex-specific differences in KRT incidence and prevalence using data from nine countries reporting to the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry for at least 40 years, during the period 1965-2015. Sex distribution data were compared with the European general population (Eurostat). Statistical methodology included basic descriptive statistics, incidence and prevalence calculations per million population (pmp), as well as their male-tofemale ratios. Analyses were stratified by age group and diabetic status. Results We analyzed data from 230,378 patients receiving KRT (38% women). For all KRT modalities, the incidence and prevalence rates were consistently higher in men than women. For example, the KRT incidence increased from 8 pmp in 1965-1974 to 98 pmp in 2005-2015 in women, whereas it rose from 12 to 173 pmp in men during the same period. Male-to-female ratios, calculated for incident and prevalent KRT patients, increased with age (range 1.2-2.4), showing consistency over decades and for individual countries, despite marked changes in primary kidney disease (diabetes more prevalent than glomerulonephritis in recent decades). The proportion of kidney transplants decreased less with age in incident and prevalent men compared with women on KRT. Stratified analysis of patients who were diabetic versus nondiabetic revealed that the male-to-female ratio was markedly higher for kidney transplantation in patients with diabetes. Conclusions Since the beginning of KRT programs reporting to the ERA-EDTA Registry since the 1960s, fewer women than men have received KRT. The relative difference between men and women initiating and undergoing KRT has remained consistent over the last five decades and in all studied countries.

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Section: Discussionmentioning

confidence: 99%

Sex Differences in Kidney Replacement Therapy Initiation and Maintenance

Antlanger

Noordzij

Luijtgaarden

et al. 2019

CJASN

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“…Mean LVEF was 61% -6% at rest; 70% -7% at peak stress ( p < 0.001). CSE was abnormal in 17 women (9.8%), with In the abnormal-CSE group of women, the following changes in CV risk behaviors over 2 years were observed: (1) a reduction of total number of alcohol drinks per week, (2) a reduction in HT use, (3) an increase in total exercise time (minutes per week), (4) an increased higher-fat diet, and (5) a decrease in the number of cigarettes smoked per day (4 of 17 women were smokers at baseline but had stopped smoking at the 2-year follow-up). However, the only statistically significant change observed was for smoking cessation (across the only smokers in the abnormal-CSE group, a mean difference of -1.5 cigarettes per day, p = 0.014) (Table 3).…”

Section: Resultsmentioning

confidence: 99%

“…1 The diagnostic accuracy of stress testing in women has historically been associated with a diminished sensitivity and specificity for detection of obstructive CAD. 2 The American Heart Association (AHA) consensus statement recommends adding an imaging modality for the evaluation of intermediate-risk women who either have a history of an abnormal exercise stress test or an abnormal baseline electrocardiography (ECG) or require pharmacologic stress testing owing to an inability to adequately exercise.…”

Section: Introductionmentioning

confidence: 99%

Effect of Stress Echocardiography Testing on Changes in Cardiovascular Risk Behaviors in Postmenopausal Women: A Prospective Survey Study

Mantovani

Abdelmoneim

Zysek

et al. 2014

Journal of Women's Health

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Background: We evaluated the impact of contrast stress echocardiography (CSE) testing results on cardiovascular (CV) risk behaviors in postmenopausal women presenting with chest pain symptoms. This was a substudy of the Stress Echocardiography in Menopausal Women at Risk for Coronary Artery Disease (SMART) trial. Methods: From 2004 to 2007, 366 women (mean age 54.4 -5.5 years, range 40-65; body mass index (BMI) 31.4 -6.68; Caucasian in 95%) completed CSE and were invited to participate in the Women's Heart Clinic Risk Assessment Questionnaire (WHCRAQ survey) at the time of CSE and after 2 years. Of the 366, 203 (55%) postmenopausal women completed both the baseline and 2-year follow-up surveys (age 61 -5 years; Framingham risk score 6 -4%, 81% treadmill CSE, 19% dobutamine CSE). WHCRAQ assessed medical history, hormone therapy (HT), and CV risk behaviors (cigarette smoking history, including current smoking and mean cigarettes smoked per day; physical activity or exercise, including mean exercise minutes per week; and dietary fat intake, alcohol intake, and mean alcohol drinks per week). Abnormal CSE was defined as a new or worsening stress wall motion abnormality. Post-CSE changes in CV risk behaviors were determined by comparing baseline versus 2-year data. Results: Of the 203 women who completed the survey at baseline and 2-year CSE, 29 were excluded to avoid confounding effect (coronary angiography [CA] was performed during follow-up). Of 174 women (55% hypertensive, 10% diabetic, 76% hyperlipidemic, and 25% on HT), CSE was abnormal in 10%. Baseline characteristics were not significantly different in normal versus abnormal CSE, apart from diabetes (8% vs. 24%, p = 0.04). Slightly more women with normal CSE were taking HT than not (27% vs. 12%, p = 0.19). CV risk behaviors that were different in normal versus abnormal CSE included current smoking, alcohol drinks per week, and higher fat diet (8% vs. 24%, p = 0.03; 2.5 -3.5 vs. 1.94 -5.2, p = 0.031; and 92% vs. 76%, p = 0.03, respectively). Cigarette smoking decreased (mean difference of -1.5 cigarettes per day, p = 0.014) in the abnormal-CSE group, whereas number of alcohol drinks per week increased (mean difference + 0.38, p = 0.009) in the normal-CSE group. Conclusion: We observed an association of lifestyle changes with CSE test results in postmenopausal women

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“…66 In 2010, a 2-day summit -Women and heart disease: a summit to eliminate untimely deaths in women -was held in Minneapolis to give straightforward directions on focusing areas of strategies and policies to ameliorate the health outcomes of women with heart disease in Minessota. 67 In 2000, the Heart and Stroke Foundation of Canada, University of Ottawa, and University of Alberta released a statement report with recommendations concerning policy development for a healthier female heart so as to support researchers, health practitioners, and policymakers in creating a community where women, irrespective of their socioeconomic status, would receive effective medical care. 68 The Heart Institute in the University of Ottawa has launched the Canadian Women's Heart Health Centre (https://cwhhc.ottawaheart.ca) with the aim of reducing CVDs in women throughmotivating individuals, health professionals, and health-care workers to address this public health concern.…”

Section: Female-centered Policies and Practices In Global Cvdmentioning

confidence: 99%

<p>Cardiovascular Diseases in Women: Policies and Practices Around the Globe to Achieve Gender Equity in Cardiac Health</p>

Kouvari¹,

Souliotis²,

Yannakoulia³

et al. 2020

RMHP

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The women's global health agenda has recently been reformulated to address more accurately cardiovascular disease (CVD) prevention, diagnosis, and treatment. The aim of the present work was to review the global and national policies and practices that address sex equality in health with a focus on CVDs in women. Scientific databases and health organizations' websites that presented/discussed policies and initiative targeting to enhance a sex-centered approach regarding general health and/or specifically cardiac health care were reviewed in a systematic way. In total, 61 relevant documents were selected. The selected policies and initiatives included position statements, national action plans, evidence-based guidelines, guidance/recommendations, awareness campaigns, regulations/legislation, and state-of-the art reports by national/international projects and conferences. The target audiences of large stakeholders (eg, American Heart Association, European Society of Cardiology, Centers for Disease Control and Prevention) were female citizens, health professionals, and researchers. Much as policy-makers have recognized the sex/gender gap in the CVD field, there is still much to be done. Thereby, tailor-made strategies should be designed, evaluated, and delivered on a global and most importantly a national basis to achieve gender equity with regard to CVDs.

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Eliminating untimely deaths of women from heart disease: Highlights from the Minnesota Women's Heart Summit

Cited by 12 publications

References 49 publications

Sex Differences in Kidney Replacement Therapy Initiation and Maintenance

Sex Differences in Kidney Replacement Therapy Initiation and Maintenance

Effect of Stress Echocardiography Testing on Changes in Cardiovascular Risk Behaviors in Postmenopausal Women: A Prospective Survey Study

<p>Cardiovascular Diseases in Women: Policies and Practices Around the Globe to Achieve Gender Equity in Cardiac Health</p>

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