Women and Heart DiseaseUnequal Burden of Disease. Patricia Davidson, MD.
Heart Disease Mortality Among Women Per 100,000 Population200                   Native American150                Hispanic...
Atherosclerosis/ hardened            arteries: PREVENTABLE  BEGINS IN THE FETUS IF THE MOTHER HAS  HIGH CHOLESTEROL OR ...
RISK FACTORS:HOW DO THEY DIFFER?
Classification of OverweightBased on Body Mass Index Overweight     >20 BMI Obese          >30 BMI    BMI= kg/m2    NHAN...
Overweight Women        by Ethnicity African   American    68.3% Asian                10.1% White                46.8%
Percent of Overweight Hispanic            Women  Hispanic        33%  Mexican         69.3%  PuertoRican     40.2%  Ne...
Diabetes    Prevalence Among Women             MIDDLE AGED    OLDER   Native Am.   21.8       31.8   Mexican Am.    7.7 ...
Diabetes DM may explain the increased risk of CAD  in African American women. Insulin resistance contributes to the  dev...
Diabetes   African American women develop DM at a lower    BMI than other women.   DM is increasing fastest in ethnic gr...
ExercisePHYSICAL ACTIVITY of FEMALE  ADOLESCENTS ( %)           Vigorous   moderate   sportsHispanic    45.2        27.6  ...
Percent of High School   Students Smoking403530                           White W25                           White M20   ...
Racial and Gender Referral           Bias
Rates of Bypass Surgery (CABG) Per 10,000 Medicare Patients:    White men              40.4    White women            16...
Variation in Use of Cardiac Procedures in  the Veterans Affairs Health System:              Effect of Race African Americ...
Effect of Race and Sex on Physicians    Recommendations for Cardiac           Catheterization   Study design: 720 physici...
Missed Diagnoses of Acute     Ischemia in the ER Risk of being sent home; Acute ischemia- 2 times higher among  African ...
Lessons From CanadaSocioeconomic Status and Access to              Care   In Ontario, despite Canada’s universal    healt...
WHAT CAN WE DO?RETURN TO OUR ROOTS.
SELF HELP GROUPS ENCOURAGE HEALTHY LIFE STYLES DISEMMINATE INFORMATION GIVE EMOTIONAL SUPPORT
TOPICS TO DISCUSS      DURING PANEL       QUESTIONS: HORMONE REPLACEMENT DIABETIC GOALS CHOLESTEROL GOALS, OPTIMAL  VER...
TOPICS TO DISCUSS      DURING PANEL       QUESTIONS: HORMONE REPLACEMENT DIABETIC GOALS CHOLESTEROL GOALS, OPTIMAL  VER...
FOOD FOR LIFE WHICH FOODS PROMOTE HEALTHY  ARTERIES WHICH FOODS PROMOTE DISEASE
Pdnational Black Women Healthproject
Pdnational Black Women Healthproject
Pdnational Black Women Healthproject
Pdnational Black Women Healthproject
Pdnational Black Women Healthproject
Pdnational Black Women Healthproject
Pdnational Black Women Healthproject
Pdnational Black Women Healthproject
Pdnational Black Women Healthproject
Pdnational Black Women Healthproject
Pdnational Black Women Healthproject
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Pdnational Black Women Healthproject

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  • Section I: Cardiovasular disease: Growing causes for concern Cardiovascular disease: Leading cause of death Content points: • The need for more effective therapy to reduce cardiovascular risk is underscored in current epidemiological data that identify cardiovascular disease as a continuing public health problem. • In 1998, cardiovascular disease (CVD) claimed the lives of 445 692 men and 503 927 women, accounting for 40.6% of all deaths. 1 • Heart disease has been the leading cause of death in this country since 1921. 2 The most recent statistics from the American Heart Association show that CVD is responsible for more deaths than the next four leading causes of death combined.
  • Pdnational Black Women Healthproject

    1. 1. Women and Heart DiseaseUnequal Burden of Disease. Patricia Davidson, MD.
    2. 2. Heart Disease Mortality Among Women Per 100,000 Population200 Native American150 Hispanic African American100 Asian American 50 White 0
    3. 3. Atherosclerosis/ hardened arteries: PREVENTABLE BEGINS IN THE FETUS IF THE MOTHER HAS HIGH CHOLESTEROL OR THE FIRST DECADE OF LIFE NOT A NATURAL PROCESS OF AGING
    4. 4. RISK FACTORS:HOW DO THEY DIFFER?
    5. 5. Classification of OverweightBased on Body Mass Index Overweight >20 BMI Obese >30 BMI BMI= kg/m2 NHANES 111
    6. 6. Overweight Women by Ethnicity African American 68.3% Asian 10.1% White 46.8%
    7. 7. Percent of Overweight Hispanic Women  Hispanic 33%  Mexican 69.3%  PuertoRican 40.2%  New immigrant 25%
    8. 8. Diabetes Prevalence Among Women MIDDLE AGED OLDER Native Am. 21.8 31.8 Mexican Am. 7.7 29.9 African Am . 14.5 25.4 White 8.5 14.5
    9. 9. Diabetes DM may explain the increased risk of CAD in African American women. Insulin resistance contributes to the development of CAD long before clinical DM. Insulin resistance is more prevalent in African American women. NHANES 1
    10. 10. Diabetes African American women develop DM at a lower BMI than other women. DM is increasing fastest in ethnic groups. 80% of children diagnosed are obese. Screening should begin by age 10. NHANES 1
    11. 11. ExercisePHYSICAL ACTIVITY of FEMALE ADOLESCENTS ( %) Vigorous moderate sportsHispanic 45.2 27.6 27.3Afr. Am. 41.2 26.4 34.9White 56.7 16.8 47.1 MMWR 9/27/98
    12. 12. Percent of High School Students Smoking403530 White W25 White M20 Af.Am W15 Af.Am M10 Hisp. W Hisp. M 5 0 White Af.Am Hisp. W W W
    13. 13. Racial and Gender Referral Bias
    14. 14. Rates of Bypass Surgery (CABG) Per 10,000 Medicare Patients:  White men 40.4  White women 16.2  African American men 9.3  African American women 6.4 JAMA 3/18/92
    15. 15. Variation in Use of Cardiac Procedures in the Veterans Affairs Health System: Effect of Race African American men after acute MI were less likely to undergo the following procedures: Cardiac cath 33% PTCA 42% CABG 54% JAMA 4/20/94, NEMJ 1993, JACC 1994
    16. 16. Effect of Race and Sex on Physicians Recommendations for Cardiac Catheterization Study design: 720 physicians viewed video tapes of actors presenting the same cardiac history and all having positive stress tests. African American women were the least likely to be referred for cardiac catheterization. NEJM 2/25/99
    17. 17. Missed Diagnoses of Acute Ischemia in the ER Risk of being sent home; Acute ischemia- 2 times higher among African American patients. Acute MI- 4 times higher compared to Caucasian patients. NEJM 4/20/00
    18. 18. Lessons From CanadaSocioeconomic Status and Access to Care In Ontario, despite Canada’s universal health care system, socioeconomic status had pronounced effects on access to specialized cardiac services as well as on mortality one year after acute myocardial infarction. NEMJ 10/18/99.
    19. 19. WHAT CAN WE DO?RETURN TO OUR ROOTS.
    20. 20. SELF HELP GROUPS ENCOURAGE HEALTHY LIFE STYLES DISEMMINATE INFORMATION GIVE EMOTIONAL SUPPORT
    21. 21. TOPICS TO DISCUSS DURING PANEL QUESTIONS: HORMONE REPLACEMENT DIABETIC GOALS CHOLESTEROL GOALS, OPTIMAL VERSUS NATIONAL GUIDELINES HYPERTENSION DRUG THERAPY MYTHS BASED ON RACE
    22. 22. TOPICS TO DISCUSS DURING PANEL QUESTIONS: HORMONE REPLACEMENT DIABETIC GOALS CHOLESTEROL GOALS, OPTIMAL VERSUS NATIONAL GUIDELINES HYPERTENSION DRUG THERAPY MYTHS BASED ON RACE
    23. 23. FOOD FOR LIFE WHICH FOODS PROMOTE HEALTHY ARTERIES WHICH FOODS PROMOTE DISEASE

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