Cardiovascular disease (CVD) is a leading cause of death of American women. Are you at risk? The American Heart Association (AHA) offers a way to classify the likelihood of developing CVD—one that goes beyond the Framingham global risk score. The Framingham score places women in categories (from high risk to optimal) based on factors like age, total cholesterol, and blood pressure. The total score has been to calculate a woman’s 10-year risk of developing the disease. The problem with this is that a low score does not necessarily reflect risk over the course of a lifetime.
With that in mind, the AHA recommends doctors take a more comprehensive view of cardiovascular risk. Adding to the Framingham score, doctors should examine the person’s medical and lifestyle history, family history of CVD, as well as other genetic conditions. The AHA aims to tackle heart disease in women by evaluating lifetime risk and determining the most appropriate preventive measures. The goals also include more aggressive tactics for those at high risk.
AHA's classification focuses on 3 categories: high risk, at risk, and ideal heart health. Women in the “high risk” category have one or more of the following:
Those “at risk” have one or more risk factors for CVD:
Women in the ideal heart health category have ideal cholesterol, blood pressure, body mass index, and fasting blood glucose values. A healthy diet, physical activity, and not smoking are also characteristic of those in this category.
There are also stroke risk factors that are sex-specific or more common in women such as:
The AHA recommends these lifestyle changes to prevent CVD for all women:
If you have high cholesterol, talk to your doctor about taking lipid lowering medications and omega-3 fatty acids. Your doctor should also screen you for depression.
In addition, if you have recently suffered a cardiovascular event, such as angina, heart attack, stroke, or peripheral artery disease, or have had heart surgery, undergo a comprehensive rehabilitative program to manage your condition and lower your risk of recurrence or other future complications.
There are many additional interventions available if you are at risk for CVD. The AHA recommends:
American Heart Association
National Heart, Lung, and Blood Institute
Canadian Cardiovascular Society
Heart and Stroke Foundation of Canada
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2/7/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Bushnell C, McCullough LD, et al. Guidelines for the prevention of stroke in women: A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(5):1545-1588.
Last reviewed April 2015 by Michael Woods, MD Last Updated: 4/21/2015