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CE Article

State of the Heart: Building Science to Improve Women’s Cardiovascular Health

Corresponding author: Anne G. Rosenfeld, RN, PhD, CNS, Associate Professor, School of Nursing, Oregon Health & Science University, 3455 SW Veterans Hospital Rd, Portland, OR 97239 (e-mail: rosenfea{at}ohsu.edu).

Cardiovascular disease is the No. 1 killer of women in the United States, and marked disparities in cardiovascular health exist between women and men and among groups of women. Coronary heart disease is underdiagnosed, undertreated, and underresearched in women. Women with suspected heart disease are less likely than men to receive indicated diagnostic tests and procedures; sex-based biases in treatment of myocardial infarction persist; and women continue to be underrepresented in cardiovascular research. An accumulating body of literature points to 3 major explanations: sex-based physiology, provider bias, and psychosocial influences. Women’s acute and prodromal signs and symptoms of myocardial infarction have been described, yet women have difficulty recognizing and acting on these indications. Primary and secondary prevention of heart disease in women is imperative; although the science is lacking in several areas, existing evidence on diet, hormone therapy, aspirin, physical activity and obesity, and diabetes can serve as the basis for interventions. Potentially, large impacts could be made on women’s morbidity and mortality if current scientific knowledge were implemented. The state of the science of women and heart disease is reviewed, with a focus on those areas with the greatest potential to address the needs of women’s cardiovascular status. Key gaps in the science and remaining questions are presented as a research agenda for the coming decade.

Notice to CE enrollees: A closed-book, multiple-choice examination following this article tests your understanding of the following objectives: Compare and contrast the prevention, diagnostic, and treatment needs of men and women with or at risk for heart disease. Describe the limitations associated with generalization and widespread application of cardiovascular research findings to date. Identify strategies for participation of nursing professionals in promoting primary and secondary prevention of cardiovascular disease in women. To read this article and take the CE test online, visit www.ajcconline.org and click "CE Articles in This Issue."