November 15th, 2011
Go Red: Highlights from the Women and Heart Disease Session
Reva Balakrishnan, MD, MPH
Several Cardiology Fellows who are attending AHA.11 this week are blogging together on CardioExchange. The Fellows include Revathi Balakrishnan, Eiman Jahangir, John Ryan (moderator), and Amit Shah. Read the previous post here. Check back often to learn about the biggest buzz in Orlando.
The past two days have been a fast-paced whirlwind of big clinical trials, so today I decided to take a break from the late-breaking madness, hang with the girls, and attend the women and heart disease oral abstract session. When I initially entered the room, I was taken aback by the sea of people dressed in red; today was Go Red for Women day at AHA, and we were asked to wear red in support. I unfortunately didn’t pack anything red to wear; but luckily I had my little red dress pin in tow!
The session was fascinating, with abstracts that highlighted the complex, multifactorial spectrum of heart disease in women. Some highlights:
Coronary vascular dysfunction, vulnerable plaque composition and response to statin therapy and the role of sex: Naser Ahmadi and colleagues used coronary CT to measure differences in the coronary distensibility index (CDI) and vulnerable plaque scores between men and women on statin therapy at LDL goal, and found that women had significantly more vulnerable plaque burden and lower CDI.
Depression is a stronger risk factor for obstructive CAD and major cardiovascular events in young women than in men and older women: Amit Shah (our CardioExchange fellow co-contributor) quantified the relationship of depression in 700+ women using PHQ-9 questionnaires with CAD using CASS scores, and found that after adjusting for traditional risk factors, depression was a significant predictor of CAD and MACE in women younger than 55 years of age, but not men or older women.
Severe physical and sexual abuse in childhood and adolescence predicts cardiovascular events in women: Janet Rich-Edwards and colleagues studied women enrolled in the Nurses Health study and the relationship between physical and sexual abuse and cardiovascular outcomes. Using the nurses health survey, they found a significant relationship between sexual abuse (forced sexual activity) and development of cardiovascular disease (hazard ratio, 1.34 – confirmed by medical record review).
Are you surprised by these results? What frontiers in cardiovascular disease in women do you think are most interesting or are still not addressed?