A Review of Cardiovascular Disease and Treatment Differences in Women

2003 ◽  
Vol 16 (3) ◽  
pp. 157-163 ◽  
Author(s):  
Mary H. Parker

Cardiovascular disease (CVD) is a significant health care problem in the United States today. Women comprise an increasing component of the population affected by this disease. Recent reports have suggested that women are not enrolled in adequate numbers in major clinical studies and, furthermore, are less likely to receive treatment as recommended by evidence-based medicine guidelines. Historical differences in the investigation and treatment of cardiovascular disease between women and men are discussed. Reasons for differences in study enrollment of women are proposed. Efforts by the Food and Drug Administration to improve data collection in women are outlined. The influence of major risk factors, including smoking, hyperlipidemia, and hypertension, on development and progression of CVD is addressed. Major trials of CVD and heart failure are examined. An assessment of progress toward a goal of gender treatment equality is made.

2021 ◽  
pp. 003335492110075
Author(s):  
Claudia Chernov ◽  
Lisa Wang ◽  
Lorna E. Thorpe ◽  
Nadia Islam ◽  
Amy Freeman ◽  
...  

Objectives Immigrant adults tend to have better health than native-born adults despite lower incomes, but the health advantage decreases with length of residence. To determine whether immigrant adults have a health advantage over US-born adults in New York City, we compared cardiovascular disease (CVD) risk factors among both groups. Methods Using data from the New York City Health and Nutrition Examination Survey 2013-2014, we assessed health insurance coverage, health behaviors, and health conditions, comparing adults ages ≥20 born in the 50 states or the District of Columbia (US-born) with adults born in a US territory or outside the United States (immigrants, following the National Health and Nutrition Examination Survey) and comparing US-born adults with (1) adults who immigrated recently (≤10 years) and (2) adults who immigrated earlier (>10 years). Results For immigrant adults, the mean time since arrival in the United States was 21.8 years. Immigrant adults were significantly more likely than US-born adults to lack health insurance (22% vs 12%), report fair or poor health (26% vs 17%), have hypertension (30% vs 23%), and have diabetes (20% vs 11%) but significantly less likely to smoke (18% vs 27%) (all P < .05). Comparable proportions of immigrant adults and US-born adults were overweight or obese (67% vs 63%) and reported CVD (both 7%). Immigrant adults who arrived recently were less likely than immigrant adults who arrived earlier to have diabetes or high cholesterol but did not differ overall from US-born adults. Conclusions Our findings may help guide prevention programs and policy efforts to ensure that immigrant adults remain healthy.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Aditi Malhotra ◽  
Smadar Kort ◽  
Tara Lauther ◽  
Noelle Mann ◽  
Hal A. Skopicki ◽  
...  

2015 ◽  
Author(s):  
Jayer Chung

There is an epidemic of cardiovascular disease in the United States, which is responsible for approximately one death every 40 seconds in the United States. Whereas the overall mortality attributable to cardiovascular disease is decreasing, the overall prevalence of atherosclerotic risk factors is increasing. Optimal management of atherosclerotic risk factors can have profound effects on morbidity and mortality after vascular surgical procedures. This review covers risk factors for the development of atherosclerosis; the evaluation of patients with vascular disease; management of tobacco abuse, hypertension, hyperlipidemia, diabetes mellitus, and antiplatelet agents; and perioperative medical management concerns in vascular surgery. Tables highlight investigational biomarkers for atherosclerosis, behavioral modification recommendations to be used to improve smoking cessation, Eighth Joint National Committee guidelines for blood pressure management, definitions of high- and moderate-intensity statin therapy, and potential future areas of research. Algorithms lay out the effects of cigarette smoke, the proposed mechanism of statin pleiotropy as it pertains to the vasculature, and the proposed mechanisms of the role of hyperglycemia in atherogenesis. This review contains 3 figures, 6 tables, and 79 references.


Author(s):  
Eric M. Patashnik ◽  
Alan S. Gerber ◽  
Conor M. Dowling

The U.S. medical system is touted as the most advanced in the world, yet many common treatments are not based on sound science. This book sheds new light on why the government's response to this troubling situation has been so inadequate, and why efforts to improve the evidence base of U.S. medicine continue to cause so much political controversy. The book paints a portrait of a medical industry with vast influence over which procedures and treatments get adopted, and a public burdened by the rising costs of health care yet fearful of going against “doctor's orders.” It offers vital insights into the limits of science, expertise, and professionalism in American politics. The book explains why evidence-based medicine is important. First, the delivery of unproven care can expose patients to serious risks. Second, the slow integration of evidence can lead to suboptimal outcomes for patients who receive treatments that work less well for their conditions than alternatives. Third, the failure to implement evidence-based practices encourages wasteful spending, causing the health care system to underperform relative to its level of investment. This book assesses whether the delivery of medical care in the United States is evidence based. It argues that by systematically ignoring scientific evidence (or the lack thereof), the United States is substantially out of balance.


2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Aditi Malhotra ◽  
Hal A Skopicki ◽  
Smadar Kort ◽  
Noelle Mann ◽  
Puja Parikh

Background: There is a paucity of data regarding prevalence of cardiovascular disease (CVD) and corresponding cardiovascular (CV) risk factors in transgender individuals. We sought to assess the prevalence of CV risk factors and CVD in transgender persons in the United States. Methods: The 2018 Centers for Disease Control’s Behavioral Risk Factor Surveillance Survey was utilized to identify a cohort of 1,038 transgender individuals in the United States. Presence of CVD was noted with a single affirmative response to the following questions: “Has a health care professional ever told you that you had any of the following:” (1) a heart attack or myocardial infarction, (2) angina or coronary heart disease, (3) a stroke? Results: Among the 1,038 transgender individuals studied, a total of 145 (14.0%) had CVD while 893 (86.0%) did not. No differences in prevalence of CVD was noted in transgender individuals who transitioned from male-to-female (n=387), female-to-male (n=400), and gender nonconforming status (n=251) (15.0% vs 13.8% vs 12.7%, p=0.72). Transgender individuals with CVD were older, had lower annual income, higher rates of smoking (28.4% vs 18.1%, p=0.004), and higher rates of multiple co-morbidities including asthma (26.6% vs 17.4%, p = 0.009), skin cancer (21.8% vs 5.0%, p <0.001), non-skin cancers (16.8% vs 6.8%, p <0.001), chronic obstructive pulmonary disease (27.5% vs 7.0%, p <0.001), arthritis (65.3% vs 28.7%, p<0.001), depressive disorder (42.7% vs 31.0%, p= 0.006), chronic kidney disease (16.2% vs 3.3%, p< 0.001), and diabetes mellitus (42.0% vs 12.7%, p <0.001). No significant differences in race, health insurance status, or body mass index was noted between transgender individuals with CVD versus those without. In multivariable analysis, independent predictors of CVD in transgender individuals included older age, diabetes mellitus [odds ratio (OR) 2.82, 95% confidence interval (CI) 1.73 - 4.58], chronic kidney disease (OR 3.69, 95% CI 1.80 - 7.57), chronic obstructive pulmonary disease (OR 2.18, 95% CI 1.19 - 3.99), and depressive disorder (OR 1.82, 95% CI 1.09 - 3.03). Conclusions: In this observational contemporary study, CVD was prevalent in 14% of transgender individuals in the United States. Predictors of CVD in the transgender population exist and transgender persons should be appropriately screened for CV risk factors so as to minimize their risk of CVD.


2020 ◽  
Vol 130 ◽  
pp. 105893
Author(s):  
Cheryl D. Fryar ◽  
Tala H. Fakhouri ◽  
Margaret D. Carroll ◽  
Steven M. Frenk ◽  
Cynthia L. Ogden

2004 ◽  
Vol 164 (2) ◽  
pp. 181 ◽  
Author(s):  
Kurt J. Greenlund ◽  
Zhi Jie Zheng ◽  
Nora L. Keenan ◽  
Wayne H. Giles ◽  
Michele L. Casper ◽  
...  

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