Cardiovascular disease is both the dominant health problem and the major cause of mortality for adult women in the US, claiming the lives of nearly 500,000 women annually. The staggering impact is that a US woman dies from cardiovascular disease almost every minute.
Although cardiovascular disease has traditionally been perceived to be a problem predominantly of men, since 1984, more US women than men have died annually from cardiovascular disease.The prominent reduction in cardiovascular mortality in the US reflects an effect in men, at least in part owing to the emphasis on preventive interventions in the male population. Of concern has been the limited awareness of the risk of cardiovascular disease for women, with little change in recent years.
A 1995 survey highlighted that four in five US women, and also one in three of their primary care physicians, were unaware of heart disease as the leading cause of death for women. Breast cancer was perceived as the major health problem. Despite contemporary public education campaigns by both governmental and voluntary health organizations, a 2003 survey by the American Heart Association (AHA) identified that only half of the women queried were aware that heart disease is their leading cause of death, with awareness among women of racial and ethnic minorities (who are at greatest risk for cardiovascular disease) lagging behind that of white women.
Of equal concern was that only a minority of respondents to the AHA survey were able to identify the major risk factors for coronary heart disease (CHD); obesity and sedentary lifestyle were cited as important by about 40% of women, with only a third identifying smoking, high cholesterol levels, or family history as risk factors, less than 20% listing hypertension, and only 7% noting diabetes.Widespread confusion was apparent regarding the role of menopausal hormone therapy in heart disease prevention. Unfortunately, a common assumption was that non-traditional methods such as vitamin use and aromatherapy were effective in cardiovascular disease prevention.
Magazines and television appeared to be the most common source of health information for women, with only about one-third of women actually having discussed heart disease and heart disease prevention with their physicians, the latter finding being more common for white than for racial and ethnic minority women.
Reinforcing the need for prevention is that women who develop clinical manifestations of CHD, particularly myocardial infarction or the need for coronary artery bypass graft surgery, do not fare as well as their male peers. Specifically, the mortality from acute myocardial infarction is almost twice as high among women younger than 65 years of age than for comparably aged men, with the mortality from coronary artery bypass graft surgery, particularly among younger women, double than that for their male peers.