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Coronary risk factors in women one year after coronary artery bypass grafting
1The Johns Hopkins University School of Nursing, Baltimore, Maryland 21205-2100, USA.
Insights
Women undergoing coronary artery bypass grafting (CABG) often retain multiple cardiovascular risk factors one year post-surgery. Effective secondary prevention strategies are crucial for improving long-term outcomes in this high-risk group.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Preventive Medicine
Background:
- Effective management of cardiovascular risk factors is critical for long-term outcomes after coronary artery bypass grafting (CABG).
- Limited data exists regarding changes in risk factor status specifically among women post-CABG.
Purpose of the Study:
- To prospectively evaluate the coronary risk factor status of women before and one year after undergoing their first isolated CABG procedure.
- To identify persistent or emerging risk factors that may impact long-term health in women post-CABG.
Main Methods:
- Prospective study of 130 women undergoing first-time, isolated CABG.
- Assessment of lipid profiles, blood pressure, weight, smoking status, and lifestyle behaviors at baseline and 12 months post-surgery.
- Analysis included demographic data such as age, education, and race.
Main Results:
- Significant reductions in smoking prevalence and daily cigarette consumption were observed.
- Despite weight loss, 58% remained obese, and dietary intake of fat, saturated fat, and cholesterol exceeded recommendations.
- Mean blood pressure increased, with 54% remaining hypertensive; no significant changes in lipid concentrations were noted, with high prevalence of elevated triglycerides, total cholesterol, and LDL.
Conclusions:
- Women frequently exhibit multiple persistent coronary risk factors one year after CABG, indicating a continued high risk for future cardiovascular events.
- These findings underscore the necessity for targeted secondary prevention interventions for women post-CABG.
- Healthcare providers should prioritize comprehensive risk factor management in this patient population.
Abstract:
Given the importance of risk factor management to long-term outcome following coronary artery bypass grafting (CABG) and the paucity of information on risk factor changes in women, a study was undertaken to examine the coronary risk factor status of women before and 1 year after CABG. This study was a prospective investigation of 130 women who underwent first-time, isolated CABG between February 1992 and October 1993. Lipid profiles, blood pressure, weight, smoking status, and other lifestyle behaviors were measured at the time of surgery and again 12 months later. The sample was 24% African American and had a mean age of 65 years and an average of 11 years of education. Substantial favorable changes in risk factor status occurred in the prevalence of smoking and the number of cigarettes smoked per day among smokers. Although the women experienced weight loss, 58% continued to be obese, and the self-reported dietary intake of fat, saturated fat, and cholesterol remained above the recommended levels of the National Cholesterol Education Program's Step II diet. Mean systolic and diastolic blood pressures significantly increased, and a substantial number of patients (54%) continued to exhibit hypertension at 1 year. No significant changes in plasma lipid concentrations were observed. At 1 year, one third of the women exceeded recommended levels for triglycerides, 78% for total cholesterol, and 92% for low-density lipoproteins. These findings indicate that women continue to have multiple coronary risk factors after CABG, putting them at high risk for future coronary heart disease events. Healthcare professionals need to target these women for effective secondary prevention.