Consider adverse social factors, racial discrimination when assessing women’s CVD risk

Important points:

• A scientific statement from the American Heart Association emphasizes considering social determinants of health when assessing CVD risk in women.
• Consideration of non-biological variables can improve equity in care.

Clinicians must consider Adverse social factors and non-biological variablesAddressing issues such as language barriers, access to health care, and discrimination can better address CVD risk among women from underrepresented backgrounds, researchers report.

In an American Heart Association scientific statement, the researchers also updated the CV risk assessment calculator to specifically address CVD in women from an underrepresented racial group, social determinants of health. and non-biological variables should be included.

“Cardiovascular disease, which is largely preventable, remains the leading cause of death for women in the United States, a reversal of progress since focusing on the sex and gender dimensions of cardiovascular disease, which is why I Since the early 2000s and the launch of the AHA’s Go Red For Women campaign in 2004, we urgently need to act. Jennifer H. Mieres, MD, FAHAFACC, MASNC, A professor of cardiology at the Zucker College of Medicine at Hofstra/Northwell in Hempstead, New York, chief of diversity and inclusion and vice chair of the Scientific Statements Committee, he told Healio. “Importantly, the statistics show a bleak outlook for women of color, especially black women, who bear the highest mortality and morbidity burden from CVD and the highest burden of CVD risk factors.”

Overall, 44% of women over the age of 20 are living with some form of CVD, and only 44% of women are aware that CVD is the leading cause of death, with cardiologists Only 42% of women report feeling prepared to adequately assess their specific CVD. Lady, Mieles said.

Limitations of traditional risk factors

The statement notes that there are many limitations to traditional risk factors and the ability to comprehensively estimate an individual’s CVD risk.

Jennifer H. Mieles

“BMI, for example, is often used as a means of identifying obesity.

Current risk assessment models do not consider gender-specific biological risk factors such as pregnancy-related factors, menstrual cycle history, medications such as contraception or hormone therapy, and medical conditions such as polycystic ovary syndrome. .

“Mental health is an additional non-traditional risk factor It has a significant impact on cardiovascular health,” the researchers wrote. “Women disproportionately suffer from anxiety and depression compared to men, and are almost twice as likely to be diagnosed with depression as men. It can occur as a result of normal hormonal changes associated with menopause.”

Consider environmental and cultural stressors

Environmental and cultural stressors are associated with increased incidences of depression in women, the statement said, leading to discrimination, inadequate social support, domestic violence, It adds that psychosocial stressors such as role, unequal power dynamics at work play an important role. play a role and may increase the risk of depression in women.

Clinicians should incorporate screening for mental health conditions such as depression and PTSD. They are more common in women and are associated with cardiometabolic risk factors and her increased risk of developing CVD.

Need for culturally sensitive education

Social determinants of health play an important role in the development of cardiovascular disease in women, disproportionately affecting women of diverse racial and ethnic backgrounds, the researchers wrote. Factors include economic stability, neighborhood safety, working conditions, environmental hazards such as air pollution, level of education and access to quality healthcare. These factors are common in underrepresented racial and ethnic communities and pose significant challenges to CVD diagnosis and therapeutic application, the researchers wrote.

The statement says that culturally sensitive, peer-led community and health professional education are “necessary steps” in CVD prevention.

“Equitable access to guideline-approved, evidence-based cardiovascular preventive care, based on available data, should be available to all women, regardless of race or ethnicity,” the researchers wrote. increase. “Despite this knowledge, these guidelines have not been equally embedded in practice, emphasizing that they are a call to action.”

Lakshmi S. Mehta

In a press release, Laxmi S. Mehta, MD, FAHA, Director of Preventive Cardiology and Women’s Cardiovascular Health at The Ohio State University Wexner Medical Center and Chair of the Scientific Statements Group, he advocates for risk assessment to include social determinants of health as risk factors. is essential to improve health outcomes for all women.

“It is also important that health care teams consider social determinants of health when making joint decisions with women about cardiovascular disease prevention and treatment,” Mehta said in a release.

For more information:

Jennifer H. Mieres, MD, FAHA, FACC, MASNC, can be reached by [email protected].

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