Go Red for Women
February 2008
The extent of women’s CVD burden
- Cardiovascular disease (CVD) is the biggest killer of women globally, killing more women than all cancers, tuberculosis, HIV/AIDS and malaria combined.1
- CVD causes 8.6 million deaths among women annually, a third of all deaths in women worldwide.1
- Every year, more women than men die of CVD.1
- Globally, 3.4 million women die of ischemic heart disease (IHD) and 3 million from stroke.1
- Women in low and middle income countries fare worse than men, experiencing a higher proportion of CVD deaths than men.2
- Women in low- and middle income countries who develop CVD are more likely to die from it than comparable women in industrialized nations.2
- In South Africa the proportion of CVD deaths in women between 35 and 44 years is 150% higher than that of women in the United States.2
- In Brazil the proportion of CVD deaths in women between 35 and 44 years is 75% higher than in US women.2
- Women’s awareness of their risk of heart disease and stroke is increasing but women often underestimate their personal risk. v
- As recently as 2004, in the United states, less than 20 % of physicians were aware that women are more likely than men to die of heart disease..vi<//font>
- In the United States, there has been less frequent use of established treatment for primary and secondary prevention in women compared to with men, this is even seen in women known to be at high-risk for CVD, such as diabetic subjects or those diagnosed with coronary artery and cerebrovascular disease. vii<//font>
Risk factors
- After menopause, women’s cholesterol levels are on average higher than those of men of about the same age.3
- After the age of 60, women’s blood pressure is on average higher than men’s.4
- A 1 cm increase in a woman’s waist measurement increases the risk of a CVD event by 2%.5
- An obese woman increases her risk of dying of CVD by 1.45 times, compared with a normal weight woman.6
- If a woman is physically inactive it increases the risk of heart disease by 1.58 times compared to women who are physically active.7
- Young women are normally at a very low risk of CVD, but they increase their risk if they smoke or have high blood pressure, diabetes, high cholesterol levels and a family history of CVD.8
- If women avoid CVD risk factors up to the menopause, they will have a very low lifetime risk for CVD and markedly longer survival.9
Under-recognition of the threat for women
- Studies show women do not perceive CVD as the greatest threat to their health.10
- Young women still feel more threatened by cancer than they do by CVD.11
- Educating women greatly increases their willingness and ability to take heart-protective action.12
Under-diagnosed and under-treated
- Women with diabetes have higher CVD mortality rates than men with diabetes.4
- Younger women who have a heart attack have higher mortality than men of the same age.4
- Women are more likely than men to become more disabled by stroke.13
- Immediately following stroke, women are more likely to experience serious problems compared to men.13
- Women are less likely to have important tests and interventions after a stroke, compared to men,13 even though life-saving emergency treatments appear more effective in women than men.14
- Women receive less aggressive treatment for CVD than men. 15,16 and this is due, at least in part, to the under diagnosis of CVD in women.17
1 World Health Organization. The World health report : 2004 : changing history. WHO, Geneva, 2004.
2 The Center for Global Health and Economic Development. A Race Against Time: The Challenge of Cardiovascular Disease in Developing Economies. The Earth Institute at Columbia University, New York. 2004.
3 Bittner V. Perspectives on dyslipidemia and coronary heart disease in women. J Am Coll Cardiol. 2005;46(9):1628-35.
4 Pilote L, Dasgupta K, Guru V, Humphries KH, McGrath J, Norris C, Rabi D, Tremblay J, Alamian A, Barnett T, Cox J, Ghali WA, Grace S, Hamet P, Ho T, Kirkland S, Lambert M, Libersan D, O'Loughlin J, Paradis G, Petrovich M, Tagalakis V. A comprehensive view of sex-specific issues related to cardiovascular disease. CMAJ. 2007 Mar 13;176(6):S1-44.
5 de Koning L, Merchant AT, Pogue J, Anand SS. Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: meta-regression analysis of prospective studies. Eur Heart J. 2007;28(7):850-6.
6 Murphy NF, MacIntyre K, Stewart S, Hart CL, Hole D, McMurray JJ. Long-term cardiovascular consequences of obesity: 20-year follow-up of more than 15 000 middle-aged men and women (the Renfrew-Paisley study). Eur Heart J. 2006;27(1):96-106.
7 Li TY, Rana JS, Manson JE, Willett WC, Stampfer MJ, Colditz GA, Rexrode KM, Hu FB. Obesity as compared with physical activity in predicting risk of coronary heart disease in women. Circulation. 2006 Jan 31;113(4):499-506.
8 Daviglus ML, Stamler J, Pirzada A, Yan LL, Garside DB, Liu K, Wang R, Dyer AR, Lloyd-Jones DM, Greenland P. Favorable cardiovascular risk profile in young women and long-term risk of cardiovascular and all-cause mortality. JAMA. 2004;292(13):1588-92.
9 Lloyd-Jones DM, Leip EP, Larson MG, D'Agostino RB, Beiser A, Wilson PW, Wolf PA, Levy D. Prediction of lifetime risk for cardiovascular disease by risk factor burden at 50 years of age. Circulation. 2006;113(6):791-8.
10 Ferris A, Robertson RM, Fabunmi R, Mosca L; American Heart Association; American Stroke Association American Heart Association and American Stroke Association national survey of stroke risk awareness among women. Circulation. 2005 Mar 15;111(10):1321-6.
11 Romero DR, Mc Mahan S, Cathorall M. Cardiovascular Disease (CVD) Risk: Should We Target College Women? Californian Journal of Health Promotion. 2005; 3 (1):117-129.
12 Mosca L, Mochari H, Christian A, Berra K, Taubert K, Mills T, Burdick KA, Simpson SL. National study of women's awareness, preventive action, and barriers to cardiovascular health. Circulation. 2006;113(4):525-34
13 Di Carlo A, Lamassa M, Baldereschi M, Pracucci G, Basile AM, Wolfe CD, Giroud M, Rudd A, Ghetti A, Inzitari D; European BIOMED Study of Stroke Care Group. Sex differences in the clinical presentation, resource use, and 3-month outcome of acute stroke in Europe: data from a multicenter multinational hospital-based registry. Stroke. 2003 May;34(5):1114-9.
14 Shah SH, Liebeskind DS, Saver JL, Starkman S, Vinuela F, Duckwiler G, Jahan R, Kim D, Sanossian N, Vespa P, Ovbiagele B. Influence of gender on outcomes after intra-arterial thrombolysis for acute ischemic stroke. Neurology. 2006;66(11):1745-6.
15 Doyle F, De La Harpe D, McGee H, Shelley E, Conroy R. Gender differences in the presentation and management of acute coronary syndromes: a national sample of 1365 admissions. Eur J Cardiovasc Prev Rehabil. 2005;12(4):376-9.
16 Blomkalns AL, Chen AY, Hochman JS, Peterson ED, Trynosky K, Diercks DB, Brogan GX Jr, Boden WE, Roe MT, Ohman EM, Gibler WB, Newby LK; CRUSADE Investigators. Gender disparities in the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: large-scale observations from the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the American College of Cardiology/American Heart Association Guidelines) National Quality Improvement Initiative. J Am Coll Cardiol. 2005;45(6):832-7.
17 Weisz D, Gusmano MK, Rodwin VG. Gender and the treatment of heart disease in older persons in the United States, France, and England: a comparative, population-based view of a clinical phenomenon. Gend Med. 2004;1(1):29-40.
v Mosca L, Mochari H, Christian A, et al. National study of women’s awareness, preventive action, and barriers to cardiovascular health. Circulation. 2006;113(4):525-34
vi Rosamond W et al. Heart disease and strokestatistics-2007 update : a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2007;115:e69-e171.
vi Hall JE et al. Hypertension and Cardiovascular Disease in Women. Hypertension. 2008;51.