10 top questions toward improving female CVD diagnosis

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Cardiovascular disease (CVD) is a leading culprit of death among women and each year; 8.6 million women die from the disease. However, because women are underrepresented in CVD clinical trials, it is difficult for physicians to understand whether women benefit from certain treatments. More gender-specific research will help improve women’s heart health, according to report put forth by the Society for Women’s Health Research and WomenHeart.

The report—10Q Report: Advancing Women’s Heart Health through Improved Research, Diagnosis and Treatment—helped outline a proper map of care for women’s cardiovascular health.

“Changes must be made to improve clinical training programs and continuing education so that clinicians recognize sex-specific symptoms of heart disease and use evidence-based cardiovascular guidelines in the treatment of women,” the report stated.

To help advance treatment for women with CVD, sex-specific predictive tools for early detection of the disease must be developed. In addition, the report said that healthcare providers should increase education of the disease and better advise women of their potential risk of heart disease.

While the Framingham Risk Score (FRS) has been the primary tool used to estimate the risk of individuals who may have cardiac events, these tests are less accurate in women. While ample treatment strategies for women remain unknown, “survival and quality of life for women with CHD or at risk of CHD could be greatly improved with advances in the development of sex-specific diagnostic and preventive strategies and risk assessment methods,” the authors wrote.

In addition, the authors added that comparative-effectiveness research (CER) must be undertaken to help determine the most efficient and accurate modalities to detect CHD and etiology of symptoms in women. Currently, the evaluation of women with myocardial ischemia remains a significant clinical challenge. While more women have angina, they also experience fewer symptoms.

The report estimated that 64 percent of women who died suddenly of CHD had no previous symptoms. Early detection of high cholesterol, hypertension, diabetes and cigarette smoking could help to reduce atherosclerosis and improve outcomes. These variables can often be modifiable with lifestyle changes. “In the future, a genetic assessment of a woman’s individual risk for the development of CHD may be possible and may guide lifestyle modification prescription and the choice and dosage of select pharmaceuticals,” the authors wrote.

They concluded that research into the biological variables that influence the development and outcomes of CHD will benefit the clinical course of patients.

The report looked at 10 questions that answers to could help improve early detection and provide a more accurate treatment strategy for women at risk for heart disease. The questions are as follows:
  • What factors influence or explain disparities in cardiovascular disease epidemiology and disease outcomes between men and women?
  •  What are the best strategies to assess, modify, and prevent a woman’s risk of heart disease?
  • What are the most accurate and effective approaches to assess and recognize chest pain and other symptoms suggesting coronary heart disease in women?
  • What role does a woman’s reproductive history and menopausal hormone therapy play in the development of heart disease?
  • What are the risk factors for cardiovascular disorders associated with pregnancy and how are they best treated?
  • What is the best method for studying sex differences in vascular injury so that cardiovascular repair therapies may be improved?
  • What are the most effective treatments for diastolic heart failure (heart failure with preserved pumping function of the heart) in women?
  • Why are young women more likely than men to die after a heart attack or after surgical revascularization procedure?
  • How do psychosocial factors affect cardiovascular disease in women?
  • What biological variables are most influential in the development and clinical outcomes of heart disease and what can be done to reduce mortality rates in women?

The report sought to call members of Congress, administration officials, researchers, healthcare providers and women to action to educate them on the important unanswered questions in the prevention and treatment of CVD in women.

You may view the full report here.