More women considered at risk for heart disease

More women will be categorized as at risk for heart diseases under new guidelines aimed at stepping up prevention and reducing the number of women who develop such conditions.

Illnesses associated with women with increased chances of developing heart disease now include systemic lupus erythematosus, rheumatoid arthritis and pregnancy complications such as preeclampsia, pregnancy-related hypertension and gestational diabetes, according to the updated American Heart Assn. guidelines published online Feb. 15 in Circulation (link).

Such conditions are known risk factors for heart disease but too often aren't recognized as such in women, said Lori Mosca, MD, MPH, PhD, chair of the guidelines-writing committee. For example, women's risk of stroke and heart disease doubles up to 15 years after pregnancy if they develop preeclampsia, she said.

"We've actually really lowered the level at which women would be considered high risk. The reason for this is because many of the current strategies and tools that we have to define high risk in women have been shown to actually underestimate the risk that a woman has," Dr. Mosca said.

More than one in three women has some form of cardiovascular disease, and 432,709 women died of heart disease in 2006, according to the latest AHA statistics.

The guidelines recommend that women being tested for cardiovascular risk also be screened for depression, because it is a common indicator of patients who fail to follow medical advice. The American Heart Assn. advises physicians to be alert to elevated risk factors among racial and ethnic groups. For example, black women are prone to hypertension and Latinas are more likely to develop diabetes.

Physicians are urged to talk routinely with patients about lifestyle behaviors, whether they take medications as prescribed and if they experience side effects.

"Improving adherence to preventive medications and lifestyle behaviors is one of the best strategies we have to lower the burden of heart disease in women," said Dr. Mosca, director of preventive cardiology at New York-Presbyterian Hospital and a professor at Columbia University Medical Center in New York City.