A unique commission that today issued major new recommendations aimed at fully understanding and reducing the global burden of heart disease in women was led by Roxana Mehran, MD, Professor of Medicine, and Population Health Science and Policy, and Director of Interventional Cardiovascular Research and Clinical Trials at the Icahn School of Medicine at Mount Sinai.
"The Lancet Women and Cardiovascular Disease Commission" developed specific, worldwide recommendations for heart disease prevention and treatment based on an unprecedented global review and analysis. The recommendations included expanding education and health programs, and research on women's heart disease. The commission's report was published on May 16 in The Lancet, and simultaneously presented at the American College of Cardiology's 70th Annual Scientific Session.
Cardiovascular disease is the leading cause of death for women around the world. There are roughly 275.2 million women diagnosed with heart disease worldwide, and 20.8 million in the United States, a majority of these cases are preventable.
The Lancet Women and Cardiovascular Disease Commission report was authored by 17 senior experts in the field from 11 countries. Their goals were to address current gaps in knowledge among physicians and patients, outline region-specific recommendations for reducing the burden of heart disease in women, and ultimately improve the outcomes of women with cardiovascular disease by 2030.
"For the first time ever, we are trying to gain a comprehensive understanding of what it may take to reduce heart disease among women worldwide. This problem has persisted unchanged for decades and this commission is a critical step toward finding solutions," says Dr. Mehran. "For example, physicians are aware that hypertension, smoking, hyperlipidemia, and diabetes are the most important evidence-based risk factors for heart disease. We now need to direct our study toward lesser-known risk factors that impact women's health. Specifically, stress, psychosocial, and economic deprivation play a pronounced but understudied role. The commission concludes that by studying these types of factors, we can better prevent, identify, and treat heart disease, reducing mortality rates and improving women's health on a global scale."
The commission's recommendations are based on an analysis of the 2019 Global Burden of Disease Study data coordinated by the Institute for Health Metrics and Evaluation - an independent global health research center at the University of Washington. Among other findings, the report highlights that women are disproportionately affected by certain risk factors for heart disease compared to men, including sex-specific factors such as preterm delivery, premature menopause, and domestic violence. Additionally, women in all stages of life are at risk of developing risk factors for heart disease, including those who had childhood obesity, and pre-eclampsia. The report points out socioeconomic factors such as education and access to care that play a significant role in the prevalence and impact of heart disease in women around the world. The review finds more attention should be directed to addressing the increasing rates of heart attack and heart disease among young women.
Based on these findings, the Commission outlined an ambitious list of ten recommendations for reducing the burden of cardiovascular disease in women over the next decade. They include educating health care providers and patients on early detection to prevent heart disease in young women; scaling up heart health programs in highly populated and underdeveloped regions; and prioritizing sex-specific research on heart disease in women and intervention strategies.
"Establishing these recommendations is an important step, but it's even more important how the ten these key messages are pragmatically implemented into concrete real-life settings. Furthermore, Mount Sinai research has also shown that in order to help reduce the global burden of women's heart disease, it's important to develop motivating heart disease prevention programs starting in early childhood and for women before and during pregnancy," says Valentin Fuster, MD, PhD, Director of Mount Sinai Heart and Physician-in-Chief of The Mount Sinai Hospital.
"These recommendations are a roadmap for combating this No. 1 killer of women around the world. It is an undertaking of massive scale and scope and will require total commitment from governments, health organizations, technology sectors, and funding agencies to prioritize this urgent need for change. It is our hope that this roadmap will be the north star for the future of women's heart health," added Dr. Mehran.
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The Commission was supported financially by grants from Abbott Vascular, Abiomed, Amgen, AstraZeneca, Bristol Myers Squibb, CSL Behring, Janssen, Medtronic, Orbus Neich, Philips, and Sanofi, who had no role in study design, data collection, data analysis, data interpretation, or writing of this Commission article. The funds were used towards the planning, development, and public launch of the Commission article. None of the authors were paid for their work on the Commission.
About the Mount Sinai Health System
The Mount Sinai Health System is New York City's largest academic medical system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai is a national and international source of unrivaled education, translational research and discovery, and collaborative clinical leadership ensuring that we deliver the highest quality care--from prevention to treatment of the most serious and complex human diseases. The Health System includes more than 7,200 physicians and features a robust and continually expanding network of multispecialty services, including more than 400 ambulatory practice locations throughout the five boroughs of New York City, Westchester, and Long Island. Mount Sinai Heart at The Mount Sinai Hospital is within the nation's No. 6-ranked heart center, and The Mount Sinai Hospital is ranked No. 14 on U.S. News & World Report's "Honor Roll" of the Top 20 Best Hospitals in the country and the Icahn School of Medicine as one of the Top 20 Best Medical Schools in country. Mount Sinai Health System hospitals are consistently ranked regionally by specialty and our physicians in the top 1% of all physicians nationally by U.S. News & World Report.
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Journal
The Lancet