[Excerpt from a presentation to group of OB-GYNs doctors.]
Women are not screened as aggressively as men because often, they present atypically. They are “blown off”. They’re told they’re crazy, need to go and see a psychiatrist, given antidepressants, when actually, they’re presenting with coronary disease.
Heart and blood vessel disease in women are different -- biologically different. We don’t know exactly why, but this has been borne out in non-angiographic studies and other things that their disease is typically more diffuse – more widespread. I think some of that’s biology. I think some of that is that women present much, much later in the disease process, because here in the South, “Momma” takes care of everybody else before “Momma takes care of Momma”.
I will show you - from 2004 data.
Green is men; blue is women. This is angioplasty. This is peripheral intervention. This is ICD therapy for sudden death. And this is ICD therapy with heart failure therapy.
Look at men versus women. They’re just not getting the same care! Now, you’ll say, “Well, they all have pacemakers, and in equal amount?” That’s because if you come the hospital and you have complete heart block, you can’t leave without a pacemaker.
[Excerpt from a presentation to group of OB-GYNs doctors.]
Here’s another study I want to share with you.
Adherents to a low-risk, healthy lifestyle and the risk of sudden cardiac death among women.
This was published in JAMA this summer. So what they wanted to do in this trial was to estimate the degree at which an adherence to a healthy lifestyle may lower the risk of sudden death among women.
They took 81,000 women that were in the nurse’s health study from June ’84 to June 2010 and did a lifestyle questionnaire about every two years. What they defined was low-risk lifestyle -- don’t smoke, exercise, your body mass had to be less than 25, and exercise 30 minutes a day or longer. The top 40 percent of the alternative Mediterranean diet score -- just lots of vegetables, fruits, nuts, legumes, whole grains, fish, moderate intake of alcohol.
The end point was sudden death within one hour of first symptom… so pretty good study. What this showed was the P values were .001 for smoking, exercise, BMI, and the Mediterranean diet score. Very powerful data that says, “Yes, this is clearly associated with reduction of risk for sudden cardiac death.”
What did they find? Now again -- a large number of patients, 82,000 -- but only 321 cases of sudden death! So not a big prevalence, but all four low-risk lifestyle factors were significantly and independently associated with a lower risk for sudden death. The proportion of sudden death attributable to smoking, sitting on your butt, being overweight, and poor diet was 81 percent!
Pretty powerful!