ORLANDO – Heart disease in women is not a top-level concern for most primary care physicians or cardiologists, according to a national survey.
Less than two in five (39%) of the surveyed primary care physicians rated heart disease as their top concern in female patients. It ranked third, behind overweight/obesity followed by breast health, even though cardiovascular disease is the No. 1 cause of death for women in the United States, Dr. Holly S. Andersen reported at the American Heart Association scientific sessions.
Dr. Holly S. Andersen
“Cardiovascular disease is the leading health care threat for women, yet public awareness and physician action have stalled, particularly in younger women and among ethnic minorities. Women are less likely to receive evidence-based preventive, diagnostic, and therapeutic strategies for cardiovascular disease,” declared Dr. Andersen, a cardiologist at New York-Presbyterian Hospital.
She presented the results of a survey of 200 primary care physicians and 100 cardiologists, all in practice for 3 or more years. The survey of a nationally representative sample was commissioned by the Women’s Heart Alliance, for which Dr. Andersen serves as scientific adviser.
Primary care physicians’ emphasis on reducing overweight/obesity as a top priority in female patients is actually counterproductive from a cardiovascular risk perspective, Dr. Andersen said. Since sustained weight loss is often a losing battle, she explained, many women who’ve failed to reduce their body weight in response to their physicians’ encouragement simply put off further office visits, and so their other cardiovascular risk factors go unaddressed.
The survey results demonstrate that awareness about heart disease in women is low among both primary care physicians and cardiologists, she observed. Among the key survey findings:
• Under a quarter (22%) of primary care physicians and 42% of cardiologists feel “extremely well prepared” to assess heart disease risk in female patients, while another 42% of primary care physicians and 40% of cardiologists consider themselves “very well prepared.”
• Less than half (44%) of primary care physicians and 53% of cardiologists use the atherosclerotic cardiovascular disease (ASCVD) risk assessment calculator introduced in the latest cholesterol management guidelines from the American College of Cardiology and the American Heart Association (Circulation. 2013 November. doi: 10.1161/01.cir.0000437738.63853.7a). Moreover, 31% of primary care physicians and 15% of cardiologists said they’ve never used it. The tool is used to calculate a patient’s estimated 10-year and lifetime risks of ASCVD. Experts consider it a cornerstone of the current guidelines.
• Less than half (49%) of primary care physicians and 59% of cardiologists say they feel their medical school training prepared them to assess female patients’ risk of heart disease.
The survey was done in conjunction with a campaign by the Women’s Heart Alliance to increase physician awareness of women’s cardiovascular risk and to prepare to take action to improve it. The upcoming campaign will promote efforts to educate women about the importance of going to their physicians to find out their personal risk levels.
Most (87%) of the surveyed primary care physicians and 82% of the cardiologists were favorably disposed to the campaign and the notion of physician education programs to address practice gaps in women’s heart risk assessment.
“What’s different about this new effort is that it will give women a single, meaningful action they can take: a routine heart check with a health care professional,” Dr. Andersen said. A key part of this heart check will include use of the ASCVD risk assessment calculator.
“By uniting with health care professionals to encourage women to not only know their numbers but understand what they mean for their heart health, the effort will help women personalize their risk so they can take the steps they need to keep their hearts healthy,” she continued.
The portion of the campaign aimed at exhorting women to visit physicians for a discussion of personal cardiovascular risk will employ as a catchphrase “#getHeartChecked.”
Support for the physician survey was provided by the National Institutes of Health, Cedars-Sinai Medical Center in Los Angeles, and several foundations. Dr. Andersen reported having no financial conflicts of interest.