Screening for Heart Disease in Women
< Mar. 28, 2012 > -- Women at risk for heart disease don't always realize it, and a new study suggests the perfect person to help assess that risk: the OB/GYN.
"It often doesn't occur to women that they could have a heart problem until their symptoms are very advanced, so we have to think differently and be creative about how we identify, educate and treat women at risk," says Roxana Mehran, M.D., at Mount Sinai Medical Center in New York City.
Many women still assume that heart disease is a problem only for men. But heart disease, stroke, and other forms of cardiovascular disease are the leading cause of death in women in the U.S.
For the study, the researchers tracked more than 2,200 women at 10 OB/GYN clinics who were screened for heart disease from January 2010 to January 2012. Nearly half of the women had gone through menopause.
The women completed a survey that asked about their heart disease risk factors and any current symptoms of heart disease they had. The clinic staff took each woman's blood pressure.
The researchers found that 69 percent of the women had risk factors for heart disease, such as obesity or type 2 diabetes. Forty-two percent had symptoms of heart disease. About 20 percent said they couldn't remember if they'd ever had their blood pressure checked before. A higher percentage said they had never been checked for high cholesterol or high blood sugar.
Among the participants, 18 percent said they considered their OB/GYN doctor to be their primary health care provider.
"Ob/gyn practices have an incredible opportunity to make an impact on heart disease in women by screening, educating and directing women to the right providers," Dr. Mehran says. "So we hope to see continued research in this area."
About a quarter of the women in the study were referred to other doctors for a closer look at or treatment of heart disease risk factors.
Dr. Mehran says that more research is needed to find out if the heart disease screenings actually help women either prevent or better manage their heart disease.
The study was presented this week at the annual meeting of the American College of Cardiology in Chicago.
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What's Your Risk?
To find out if you're at risk for heart disease, get your blood cholesterol and blood pressure checked. The higher either of them is, the greater your risk for heart disease or heart attack. A lipoprotein profile blood test will measure the fats in your blood: total cholesterol, LDL ("bad") cholesterol, HDL ("good") cholesterol, and triglycerides.
In general, you're at low risk if your total cholesterol is less than 200 mg/dL; LDL, less than 100 mg/dL; HDL, greater than 40 mg/dL (but preferably greater than 60); and triglycerides, less than 150 mg/dL.
Normal blood pressure is 119/79 or lower. If your reading is 120 to 139 for the top number and 80 to 89 for the lower number, you have pre-hypertension. This means you are likely to develop high blood pressure in the future. High blood pressure, or hypertension, is 140/90 or higher.
But your lipoprotein profile tells only part of the story. Your doctor will figure out your risk by also including other information, such as your medical history and family history of heart disease. If your risk is high, you may need cholesterol-lowering medication. Your doctor may advise you to make diet and lifestyle changes before he or she prescribes medication.
Most women can prevent heart disease by making lifestyle changes that can reduce their risk.
Always talk with your health care provider to find out more information.
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American College of Cardiology - OB/GYN Screening May Help Detect Heart Disease Risk
American Heart Association - Women and Heart Disease
National Heart, Lung, and Blood Institute - What Is High Blood Pressure?