Cardiovascular disease in women.

Abstract

A ction must be taken to prevent cardiovascular disease in women and men before signs and symptoms of the disease appear or a myocar- dial infarction or stroke is experienced.Prevention is critical because 40% of all coronary events in women are fatal, 67% of all sudden deaths in women occur in those without a history of coronary heart disease,1 and stroke is one of the leading causes of severe disability among women.Much is known about the risk factors for cardiovascular disease in women, but much less is known about the effect modification of these risk factors has on the reduction of risk in women.However, given the knowledge available, much can be done to prevent or control risk factors in women.Prevention of morbidity and death from cardiovascu- lar diseases must start in the young.Although healthy living habits should begin in childhood, this report focuses on cardiovascular diseases among postmeno- pausal women entering the coronary heart diseaseand stroke-prone years.The discussion is extended to younger women where applicable: for example, in the sections on oral contraceptives and prevention and control of risk factors.Because of the growing number of older women in the population and those at risk for cardiovascular disease, the diagnosis and treatment of heart disease, stroke, and peripheral arterial disease are vital.General Considerations Cardiovascular diseases, especially coronary heart disease and cerebrovascular disease, are the leading causes of death in women in the United States and claim more black women's and white women's lives than do cancer, accidents, and diabetes combined.2Each year more than 236 000 women die of a heart attack, and more than 87 000 women die of a stroke.The age-adjusted death rates from diseases of the heart in women are four times higher in white women and six times higher in black women than the death rates for breast cancer.From 1980 to 1989 there was a 27% decline in age-adjusted death rates from coro- nary heart disease and a 65% decline in death rates "Cardiovascular Disease in Women" was approved by the Science Advisory Committee of the American Heart Association on February 17, 1993.