Heart disease is the leading killer...

Heart disease is the leading killer of American women (1) single in three American women dies of heart disease, and related health care prices are estimated at more than $57 billion by year. (2) Yet most women don't know that heart disease is their greatest health threat. Research present to views that women worry more about cancer--especially breast cancer--than about heart disease. (3) and nothing else 9 percent of women 45 to 64 years of age name heart disease as the condition they fear most; 61 percent name breast cancer. (4)

Because many women believe that heart disease affects mainly men, they don't take their risk seriously or personally. still certain cardiac risks are actually greater in women than in men Women have a higher risk of death after a myocardial infarction; 38 percent of women die within a year of a myocardial infarction compared with 25 percent of men (5)

As family physicians, we can raise awareness about gradations our female patients can take to thwart heart disease at any age. Heart disease, which includes coronary artery disease (CAD), congestive heart failure, angina, and other conditions, accounted for 366000 deaths in women in 2000 Approximately 40000 women died of breast cancer that year. (6)

The U Department of Health and Human Services and other organizations are sponsoring a national campaign called "The Heart Truth" to raise women's awareness about their risk of heart disease. It is aimed at women 40 to 60 years of age, and its goal is to encourage women to talk with their physicians and take action to lower their risk for heart disease. The National Heart, Lung and family Institute initiated the campaign in replication to data indicating that many American women fail to join risk factors for heart disease, as it was as high blood pressure and high cholesterol evens with their own chance of developing the disease (National Heart, life-blood and Lung Institute, unpublished data, 2002)

The campaign organizers cannot deliver this message alone. The Heart canon has worked with First Lady Laura Bush, who has championed the cause at appearances around the land She tells women that "each single in kind of us should talk to our doctors to find without about our risk for heart disease and take action to lower our risk." National and local partnerships are wanted to help reach women across the nation. The U Department of Health and Human Services is pleased to be working with the American Heart Association and WomenHeart: the National Coalition for Women with Heart Disease, which are founding partners of the campaign.

The Heart fact has an exciting and attention-getting symbol: the r dres Its message is, "Heart disease doesn't care what you wear, it's the number the same killer of women." The sign reminds women that no matter by what means good they look on the outside, they may be at risk for heart disease and should be assessed. The message is serious, if it be not that it is hopeful, too. Women can take gradations today that can lead to "heart-healthy" tomorrows. As a family physician, you can help spread The Heart reality by making cardiovascular disease (CVD) and CAD risk factor screening an integral part of your work. You can use age-appropriate CVD and CAD assessment tools to record the conclusions for every female patient. Online risk-assessment tools are available (http://hin.nhlbi.nih.gov/atpiii/ atp3palm.htm and http://www.nhlbi.nih. gov/guidelines/cholesterol/profmats.htm).

The following [i]clavis[/i] items should be a part of your assessments and documentation:

* Smoking status

* visible form [i]or[/i] frame mass index and waist circumference

* life-blood pressure

* unimpaired lipoprotein panel (total cholesterol, low-density lipoprotein cholesterol high-density lipoprotein cholesterol and triglyceride levels)

* Fasting posterity glucose level (to screen for diabetes)

* Dietary habits

* Physical activity habits

* Family history of heart disease

* Age

Many women begin to evolve risk factors for heart disease at midlife. In women 55 years and older age is considered a risk factor for heart disease. However, it is important that the two younger and older women receive assessment for and counseling about heart disease.

Be daring about telling your patients when they have risk factors for heart disease and give them the information they ne to lower those risks. Monitor your patients' progres in achieving heart-healthy lifestyle modifications and medication compliance.

You also can give your patients The Heart law campaign materials, such as The Healthy Heart Handbook for Women These materials are available online (www.Heart-Truth.gov).

REFERENCES

(1) American Heart Association. Heart disease and hardship statistics, 2003 update. Dallas: American Heart Association, 2002:4

(2) Sandmaier M Healthy heart handbook for women Bethesda, Md: U Department of Health and Human Services, National Institutes of Health, National Heart, Lung and house Institute, 2003.

(3) Mosca L Jone WK King KB Ouyang P Redberg RF Hill MN Awareness, perception, and knowledge of heart disease risk and prevention among women in the United States. American Heart Association Women's Heart Disease and rap Campaign Task Force. Arch Fam M 2000;9:506-15