The American Heart Association (AHA) has released new guidelines for preventing and treating cardiovascular disease in women. The guidelines recommend tailoring the aggressiveness of treatment to a woman's risk of experiencing a cardiovascular event such as myocardial infarction (MI) within 10 years. Under a standardized scoring system developed from Framingham Heart Study data, lower risk of MI is defined as less than 10%, intermediate risk as 10% to 20%, and high risk as over 20%. The guidelines also identify an optimal risk group for women with optimal scores for risk factors and heart-healthy lifestyle; the risk for this group is also less than 10%.
Women in the lower-risk group may have metabolic syndrome or just one or no risk factors. Those in the intermediate-risk group may have high blood pressure or high cholesterol levels but no signs or symptoms of heart disease. Those in the high-risk group may have evidence of cardiovascular disease, such as peripheral arterial disease, abdominal aortic aneurysm, or cerebrovascular disease.
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Lifestyle interventions, such as smoking cessation, weight control, regular exercise, and a heart-healthy diet, are a high priority for women in all groups. Other recommended interventions depend on risk category. For example, aspirin, angiotensin converting enzyme inhibitors, and statins are recommended for all high-risk women (unless contraindicated), even if their low-density lipoprotein cholesterol levels are normal. Aspirin use isn't currently recommended for lower-risk women because bleeding risks outweigh the benefits. For women with intermediate risk, health care providers should weigh the benefits of aspirin and other interventions against possible drawbacks. Women with cardiovascular disease should also be screened for depression.
Representatives from the AHA and 11 other professional and federal groups wrote the new guidelines, which incorporate findings from hundreds of studies. Learn more from the AHA's Web site at http://www.americanheart.org.
"Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women," Circulation, L. Mosca, et al., February 10, 2004.