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Hypertension and other cardiovascular risk factors in women
1Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Insights
Coronary heart disease (CHD) is a major health concern for women, with prevalent risk factors like hypertension and obesity. Addressing these factors is crucial for improving women
Area of Science:
- Cardiovascular Health
- Women's Health
- Public Health
Background:
- Coronary heart disease (CHD) is the leading cause of death for women in the U.S., resulting in approximately 250,000 deaths annually.
- CHD significantly impacts women's quality of life, with over one-third of women aged 55-64 experiencing disability, rising to 55% in those 75 and older.
- Risk factors such as hypertension, hypercholesterolemia, overweight, and sedentary lifestyles are highly prevalent in U.S. women aged 20-74.
Purpose of the Study:
- To highlight the significant burden of coronary heart disease (CHD) in U.S. women.
- To examine the prevalence of major cardiovascular risk factors in women across different age groups and demographics.
- To underscore the disparities in risk factor reduction and mortality rates between men and women over recent decades.
Main Methods:
- Analysis of epidemiological data on coronary heart disease (CHD) mortality and disability in U.S. women.
- Assessment of the prevalence of key risk factors including hypertension, hypercholesterolemia, obesity, diabetes mellitus, and physical inactivity.
- Comparison of trends in risk factor prevalence and cardiovascular mortality between men and women over the past 2-3 decades.
Main Results:
- Hypertension is highly prevalent, particularly in older women, with rates increasing with age and being higher in women than men after 65.
- Risk factor prevalence is greater among women of lower socioeconomic status and educational attainment.
- While men have shown greater decreases in coronary risk factors and mortality, women's trends have lagged, with smoking cessation rates equalizing prevalence.
Conclusions:
- Coronary heart disease (CHD) poses a substantial and growing threat to women's health, exacerbated by prevalent and persistent risk factors.
- Hypertension and other risk factors disproportionately affect women, especially older women and those with lower socioeconomic status.
- Targeted preventive strategies and increased awareness are essential, as women's understanding of CHD as part of their illness experience is key to adopting preventive measures.
Abstract:
Coronary heart disease (CHD) is the leading cause of death in U.S. women, causing about 250,000 deaths annually. More than one-third of women aged 55 to 64 with CHD are disabled by their disease, and this increases to 55% in women 75 years and older. Risk factors are highly prevalent in U.S. women aged 20 to 74 years: > 1/3 have hypertension, > 1/4 have hypercholesterolemia, > 1/4 are overweight, and > 1/4 are sedentary. Additionally, diabetes mellitus imparts greater risk for women than for men. Risk factor prevalence is greater in women of lower socioeconomic status and lower educational level. The decrease in coronary risk factors has been less pronounced in women than in men in the past 2 to 3 decades; the decrease in coronary and cardiovascular mortality has also been less pronounced for women than for men. For example, 51% of white women and 79% of black women > 45 years of age have hypertension; 71% of women > 65 years of age have hypertension. Systolic blood pressure peaks in middle age for men but continues to increase in women until beyond age 80. Hypertension is more prevalent in women than men after age 65, and women incur more complications than men from hypertension. There is an equal current prevalence of cigarette smoking in both genders due to increased smoking cessation in men. Cigarette smoking doubles to triples the risk of myocardial infarction, even in premenopausal women. Young to middle aged women have higher HDL cholesterol and lower LDL cholesterol levels than men. Total cholesterol levels in white women increase with age at least to age 70; LDL cholesterol levels rise progressively to exceed those in men. The postmenopausal increase in total cholesterol is far less in black women. The association of physical fitness with a more favorable coronary risk profile is more pronounced for women than men. Education is important; unless women consider CHD as part of their illness experience, they are unlikely to heed preventive messages.