DALLAS – A mere 28% of 1,013 surveyed New York–area women correctly identified cardiovascular disease as the No. 1 killer of women. And two-thirds of those women said their primary care provider is an obstetrician-gynecologist who does not discuss heart health as part of preventive care, Dr. Allison J. Brusati reported at the American Heart Association scientific sessions.
"In a population with extremely low levels of awareness of cardiovascular disease and a high reliance on ob.gyn. care – and particularly young, reproductive-age women – ob.gyns. are not only well poised but [also are as] obligated as primary care clinicians to provide heart-health education to their patients. Without adding much time to a patient’s annual visit, an ob.gyn. can discuss a woman’s risk factors and advise lifestyle changes that may prove essential in preventing heart disease as well as other chronic diseases," asserted Dr. Brusati of Albert Einstein College of Medicine in New York.
Dr. Allison Brusati
The 28% rate of awareness of heart disease as the top killer of women in this New York survey is exactly half the rate found in a recent AHA-sponsored national survey of women (Circulation 2013;127:1254-63). The survey was conducted at five ob.gyn. clinics affiliated with Montefiore Medical Center, four situated in largely impoverished sections of the Bronx and one in wealthy Westchester County. The survey population was 40% Hispanic, 31% black, and 20% white. Only 21% of non-white women, compared with 55% of white women, were able to identify cardiovascular disease as the top killer of women.
"Younger women with lower income levels and without a higher degree of education were more likely to be unaware of their risk of heart disease," said Dr. Brusati. Still, education was no guarantee of being heart-health savvy. Of survey respondents who had a college degree or higher, 44% identified cardiovascular disease as the top cause of mortality in women, 42% thought cancer was the top cause of death in women, and 20% had no idea of the No. 1 cause of death.
The survey also found that most of the ob.gyns. who served as primary care providers for the New York women also failed to discuss other key aspects of primary prevention beyond heart health. Smoking was discussed by 51% of ob.gyns, exercise by 42%, diet by 38%, and colonoscopy by 32%. Mammography was discussed by 75% of ob.gyns.
Dr. Brusati’s coinvestigator in this unfunded study was Dr. Mary L. Rosser, an ob.gyn. at Montefiore Medical Center. They reported having no financial conflicts.