Sudden Cardiac Death and cardiovascular disease is the number one killer of women in the US second only to ALL cancers COMBINED. The prevalence of coronary artery disease in women is similar to that in age-matched cohorts of men– yet women tend to be under-served and under-treated. When we look at specific interventions such as Percutaneous Coronary Interventions (PCI or coronary stenting) and Implantation of Implantable Cardioverter-Defibrillators (ICDs), and advanced devices for Congestive Heart Failure, we find that men tend to have more access to advanced therapies and are undergoing procedures at two to three times the rate of women.
First published 6/23/11 on the American Family Physician Community Blog
In 2002, the U.S. Preventive Services Task Force (USPSTF) strongly recommended that primary care clinicians discuss preventive aspirin use with adults at increased risk of cardiovascular events. Four years later, the National Commission on Prevention Priorities (NCPP) ranked counseling for aspirin use the number one priority on its list of the most effective clinical preventive services. According to the NCPP, if the percentage of eligible patients using aspirin (then estimated to be about 50 percent) increased to 90 percent, 45,000 additional lives could be extended each year.
At that time, the benefits of aspirin use in men and women were assumed to be the same. However, an updated USPSTF recommendation statement published in the June 15th issue ofAmerican Family Physician indicates that aspirin use actually prevents heart attacks in men, but ischemic strokes in women. In addition, physicians and patients must weigh the benefits of reduced cardiovascular risk with the risk of gastrointestinal bleeding events, and use shared decision making when these risks are closely balanced.
The Chicago Tribune had an important series over the weekend exposing conflicts of interest in the cardiovascular medical device industry, and the loopholes in regulatory oversight that allowed what appears to be a dangerous heart valve replacement part to escape Food and Drug Administration scrutiny. The latter story is by far the more important one. Here’s the details, from the Trib website:
Instead of being grouped with heart valves and implantable pacemakers, annuloplasty rings were put into a class with most catheters, sutures and hearing aids, which allows the medical device industry to gain approval for new rings without clinical studies.
Note by Bill Bestermann, MD. Dr. David Carmouche works at the Baton Rouge Clinic in Baton Rouge, Louisiana. He runs a Center for Cardiovascular Disease Prevention within the clinic and works full time in clinical practice producing optimal medical therapy in high risk patients. Dr. Carmouche is certified in lipid management by the National Lipid Association, and is recognized by his peers as an expert in lipid management.
He is actively involved in multiple leadership roles that are characterized by the common theme of more effectively treating cardiovascular disease with lifestyle and medical interventions. A group of about 20 academic and community cardiovascular risk experts asked him to lead the development of the cholesterol treatment section of a program describing optimal medical therapy for metabolic syndrome patients.