By DrRich
Updated: December, 2005
While many women apparently still do not know it, heart disease is the number one killer of women. About a half million women die of heart disease each year in the U.S. - indeed, more women die than men from cardiovascular disease.
Accordingly, some time ago an expert panel was commissioned by the American Heart Association to formally study the problem of heart disease in women. This panel systematically reviewed the medical literature, has now published the first set of formal, evidence-based guidelines on preventing cardiovascular disease in women. Their report was recently published in Circulation.
The panel evaluated numerous possible preventative measures - both lifestyle changes and medical interventions - and only those that had proven scientific merit were included in the final recommendations. The panel also attempted to classify the degree of proof that these preventative interventions actually reduce risk, as follows:
- Class I interventions are those that are proven useful and effective
- Class IIa interventions are those in which the weight of evidence supports their usefulness and effectiveness, but does not constitute real proof.
- Class IIb interventions are those in which there is at least some evidence they are useful/effective, but the evidence is less well established.
- Class III interventions are not useful or effective, and may be harmful
The Guidelines and how to use them
For a woman who wants to use these guidelines to reduce her cardiovascular risk, the first step is to calculate her present 10-year risk of developing significant heart disease. ( For several easy-to-use on-line risk calculators, click here.) Based on this 10-year estimate of risk, she next would place herself into one of three categories: High risk (10-year risk of developing heart disease is greater than 20%), Intermediate Risk (10-year risk is 10% to 20%) and Low Risk (10-year risk is less than 10%). Specific recommendations for preventing heart disease are set out for each of these 3 risk categories.
Class I Recommendations for All Women
The recommended preventative measures are a bit different for each of these 3 risk categories. However, for all 3 categories the following Class I (i.e., proven) preventative interventions are recommended:
- Smoking cessation
- Increase physical activity
- Heart healthy diet
- Weight maintenance/reduction
In other words, each of these well-known preventative measures are proven to reduce risk, and should be adopted by all women.
In addition, the following recommendations are made:
High risk women (>20% risk)
Class I recommendations -
- Blood pressure control
- Lipid control/statin therapy
- Aspirin therapy
- Beta blocker therapy
- Ace inhibitor therapy
- Blood glucose control
Class IIa recommendations -
- Evaluate and treat for depression
Class IIb recommendations -
- Omega 3 fatty acid supplements
- Folic acid supplements
Intermediate risk women (10% to 20% risk)
Class I recommendations -
- Blood pressure control
- Lipid control
Class IIa recommendations -
- Aspirin therapy
Lower-risk women (<10%)
Class I recommendations -
- Treat individual risk factors as indicated
You can read what you can do about individual risk factors here.
