The World Heart Federation has chosen International Women's Day on March 8th to launch the first international heart health advocacy drive for women as part of its Go Red for Women campaign. Cardiovascular disease (CVD) is the biggest single killer of women(1) and the advocacy drive, being run by foundations and cardiology societies in over 30 countries worldwide, aims to raise awareness of the disease and encourage policy-makers, healthcare professionals and women themselves to take action. On March 8th the World Heart Federation is issuing an advocacy campaign kit for its participating members worldwide.
CVD has traditionally been seen as a "man's illness", but it ends the lives of almost as many women as men. Of 17.5 million deaths from CVD each year over 8.6 million are women, more than the total number who die from all cancers, tuberculosis, HIV/AIDS and malaria combined(2). But most of these deaths could be prevented and, through Go Red for Women, the World Heart Federation is seeking to effect the changes necessary to achieve this, beginning by increasing awareness.
Supported by Elizabeth Arden as well as film actress Catherine Zeta-Jones, Go Red for Women is an international campaign to encourage women to take charge of their heart health, urge policy-makers to include CVD in the women's health agenda and ask medical professionals to proactively support the prevention, diagnosis and treatment of CVD in women.
"CVD is indisputably the most serious neglected health problem for women in both the developing and the developed worlds," said Dr Sania Nishtar, Chairperson of the World Heart Federation's Women and Heart Disease Expert Panel. "The lack of awareness among women is especially grave in countries of low or middle-income where the focus of ministries of health has been almost exclusively on maternal and child health."
Limited data on awareness reveals alarming knowledge gaps throughout the world. In Singapore just 8% of women know that CVD poses such a threat(3), while in Australia among the total population awareness of women's risk drops to 3%(4). Even in the United States, where awareness has grown partly through the success of the Go Red for Women campaign, in 2006 only just over 20% of women were aware of their biggest health risk(5).
Contributory factors vary. Obesity among women over 15 stands at 56% in South Africa (compared to 29% of men)(6) and 46% in Egypt(7). In Chile nearly one third (32%) of women above 15 smoke(8), while in Spain it is nearly a quarter (23%)(9). In the Colombian capital of Bogota 79% of women are physically inactive(10), as are 70% in Indonesia(11). And hypertension affects a million women (51%) in the Jaipur region of India alone(12).
"The issue of women's heart health is neglected," continued Dr. Nishtar. "The persistent myth of women's invulnerability to CVD probably does much to explain the extent to which the healthcare sector ignores the grave impact of heart attack and stroke on women. The World Heart Federation will do everything in its power to inform women, policy makers and physicians. As recently as the 1980s many physicians did not even believe that women developed CVD." Furthermore, the Research on Cardiovascular Disease in Women funded by the US Agency for Healthcare Research and Quality found that among 810 selected scientific articles on CVD only 162 provided evidence for women(13).
The presentation, progression and outcomes of CVD in women differ from those in men, with women more likely to die or suffer disability from a re-attack or heart failure(14). Studies have also shown they are less likely to be prescribed aspirin for prevention of a second attack, to receive sophisticated pacemaker models or to be recommended for potentially life-saving cardiac surgery(15).
"The aim of the Go Red for Women advocacy drive is to make the number one killer of women a much more important healthcare priority," said Professor Shahryar Sheikh, President of the World Heart Federation. "This means creating more prevention activities at a community level, developing better tools in clinical practices to identify CVD in women and providing access to first and second-line treatment to women."
At the policy-maker level the aim is to ensure the continued advocacy of institutions such as WHO and the World Bank; to put women and CVD on national health policy agendas; to increase the diffusion of awareness messages; to raise more funding for specific gender-oriented CVD campaigns; and to modify the Millennium Development Goals so that CVD is included. "Although the overarching goal of the UN Millennium Declaration is to halve world poverty by 2015, it is highly doubtful that this can be achieved without a concerted effort to prevent a disease that kills 8.6 million women annually," added Professor Sheikh.
For healthcare providers, including general and specialized physicians as well as nurses and midwives, the goal is to secure the inclusion of modules on CVD in women at medical training and internship level; to make sure awareness messages reach a wider population of physicians (for example pediatricians, obstetricians, gynecologists, endocrinologists and geriatricians); and that the message is passed on to patients in general and women in particular through healthcare follow-up, nurses' training colleges, women's community groups or whatever means are available.
"There can be no more suitable day than International Women's Day, recognized all over the world for the past century, to bring the most important health issue facing women in the 21st century to the attention of stakeholders everywhere," concluded Professor Sheikh.
About the World Heart Federation
The World Heart Federation is a nongovernmental organization based in Geneva, Switzerland dedicated to the prevention and control of heart disease and stroke, with a focus on low- and middle-income countries. It comprises 196 member societies of cardiology and heart foundations from over 100 countries covering the regions of Asia-Pacific, Europe, East Mediterranean, the Americas and Africa. For further information visit: World Heart Federation
About the European Society of Cardiology
The European Society of Cardiology (ESC) represents more than 50,000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe. The ESC has sponsored various initiatives to raise awareness of gender issues in the diagnosis and treatment of CVD, including the European Heart Health Charter and the Women at Heart programme.
European Society of Cardiology
References
1. WHO World Health Report 2002
2. Based on the latest WHO estimations
3. Singapore Heart Foundation Go Red for Women Survey, 2006
4. Pfizer Australia Health Report, 2004
5. Harris Interactive Survey for the AHA, 2006
6-12. WHO Global Infobase 1998-2006
13,14. WHO, US Agency for Healthcare Research and Quality, US Food and Drug Administration.
15. Ricciotti, H, MD. Heart Disease: Are men and women different? Beth Israel Deaconess Medical Center, Boston, March 2003
European Society of Cardiology
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