Fiction: Cardiovascular disease kills more men than women.

Fact: Cardiovascular disease is an equal-opportunity killer. More than 250,000 women die from myocardial infarction and more than 100,000 die from strokes annually. 1 Cardiovascular disease is responsible for 45% of all deaths in women. One woman dies every minute from cardiovascular disease.

Fiction: Estrogens, whether endogenous or exogenous, provide protection against cardiovascular disease.

Fact: As a rule, endogenous estrogens do offer some protection to the premenopausal population. However, women with diabetics or who smoke lose any protection against coronary artery disease. In addition, hormone replacement therapy increases the risk of embolic events.

Fiction: Women should fear breast cancer more than cardiovascular disease.

Fact: Breast cancer will affect approximately 1 in 8 women, whereas cardiovascular disease will affect 1 in 3.

Fiction: More young men die from an MI than young women.

Fact: Younger women are more likely to die from an MI than their male counterparts.

These are just a few misconceptions about women and cardiovascular disease (CVD). Unfortunately, these fallacies do not just exist in the public domain but also in much of the medical community. Despite a decline in CVD mortality rates over the past several decades, the absolute number of women dying continues to rise. [Heart Disease and Stroke Statistics 2003 Update. Dallas, TX: American Heart Association; 2002.] Manifestation of disease in women differs from that of men, such that diagnosis and treatment are frequently delayed. If women do receive aggressive treatment, such as angioplasty or coronary artery bypass surgery, their outcomes are worse. Because women have comprised small percentages of total enrollment in randomized clinical trials, treatment of CVD in women has been largely empirical.1 Finally, the Women's Health Initiative contradicted much of the beliefs about the benefits of estrogen therapy for CVD.

I am proud and honored to serve as guest editor on this issue of The Journal of Cardiovascular Nursing: Women and Heart Disease. It is always a pleasure to work with my friends and colleagues, especially on a topic with such importance. In this issue, we explore the gender differences associated with CVD, including pathophysiology, diagnosis, outcomes, prevention, and treatment. I hope you find these articles informative and applicable to your clinical environment. After all, it's time to remove the barriers and improve the cardiovascular health for women everywhere. It's time to save lives of women we love!

Robin Trupp

REFERENCES