女性心脏病PPT.ppt

Why?? Awareness Risk factors “Atypical” symptoms Treatment 38% CP1021901-10 Women whose doctor discussed heart disease prevention 2003 AHA Survey Mosca, Circulation 2005 *MD’s systematically underestimate CVD risk and in women vs. men …after an ED visit for symptoms of unstable angina, the use of cardiac procedures was lower in women, but after taking into account baseline characteristics, men experienced worse outcomes. CP1141913-3 JAMA , 2001 Sex Disparities in MI Treatment US National data CP1074357-7 35,835 pts with NSTEMI- 41% women Women - ?DM, HTN, age, ? CAD events ? Early ASA, heparin, GPIIb-IIIa, ACE-I ? Revascularizations – (CABG ? 41%) ? Discharge ASA, ? blocker, ACE-I, statins ? Death, MI, CHF Blomkains, JACC 2004 CRUSADE NSTEMI database MIs(%) ‘83 ‘85 ‘82 ‘84 ‘86 ‘87 ‘88 ‘89 ‘90 ‘91 ‘92 ‘93 ‘94 ‘95 ‘96 ‘97 ‘98 Year Men, 1056 Women, 765 CP1099138-2 Witt, et al; JACC 2004; 44: 988-96 Secondary prevention after MIin our practice1821 persons with MI, participation 55% Summary of treatment differences In every circumstance, sex disparities in treatment have been documented Women are less likely to get aggressive treatment than men These disparities identify opportunities for improvement ACTION PLAN Mosca, Circulation. 2004;109:672– 693 CP1170099-24 CVD Prevention Women’s Guideline Resources Framingham CHD risk score ADA (diabetes) JNC VII (HTN) DASH (HTN) NCEP-ATP III (lipids) NHLBI Obesity Management Surgeon General’s Report (tobacco) americanheart.org acc.org CP1170099-33 We need to: Address identified evidence gaps Disseminate guidelines broadly Non-CV professional publications Increase public awareness Raster Image \rasters\986192-01.tif From CP986192-4 From CP986192-5 From CP986192-4 Heart Disease In Women 2005 Great Wall Meeting Beijing Véronique L. Roger, MD, MPH Professor of Medicine Mayo Clinic College of Medicine Outline The growing burden of heart disease in women Mortality Prevalence-Incidence Outcome Explanations for disparit