Cardiac Disease In Womens Publich Health
Cardiac Disease in Womens Public Health
Cardiovascular disorders followed by malignancies and trauma are leading causes of mortality worldwide. The World Health Organization reported that in 2008, cardiovascular diseases were the major causes of non-communication deaths. The most widespread were the coronary heart disease, arterial hypertension, and congestive heart failure (WHO, 2014). It is believed that men typically suffer from heart troubles, but epidemiological studies suggest that actually more women than men die from cardiac diseases each year (Mayo Clinic Staff, 2014). This paper discusses epidemiology, social aspects, and gender differences of cardiac problems.
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The American Heart Association states that cardiovascular disorders are the main causes of death in American women. In 2009, one in 30 women died from breast cancer, but one in 3 died from cardiovascular maladies. Nearly one woman dies each minute from cardiac diseases in the United States of America giving over 400,000 lives each year (Go et al., 2013). The same source states that nearly two-thirds of women died suddenly without any previous symptoms.
Before the 1950s, little was known on how to prevent or treat cardiac problems in the adults conclusively. For example, cigarette smoking was not blamed for shortening life expectancy, and cholesterol blood level was generally ignored (ODonnella & Elosua, 2008). However, with the introduction of various medical epidemiological trials, the scientists have managed to improve our knowledge. Thus, in the following decades, mortality from cardiac disorders in female has decreased from 470,000 deaths per year in 1979 to nearly 400,000 in 2009 (Go et al., 2013). Albeit, even today almost a half of women are unaware that heart disorders is the chief cause of death among females. Many women ignore their heart symptoms, and only 53% say they would call 911 if they were having a heart attack (Mosca et al., 2010). In medical trials concerning heart diseases, men predominate. Women were engaged in less than one-third of 120 studies of medical devices in the 2000s (Dhruva et al., 2011).
Coronary heart disease is the leading killer of women in the United States of America and most developed countries. About 6.6 million of American females today have a coronary heart disease; 2.6 million of them have a history of myocardial infarction; each year more than 380,000 develop a myocardial infarction, and more than 180,000 are diagnosed with stable angina (Go et al., 2013). An estimated 66,000 more women than men die from myocardial infarction (Finks, 2013). In 2009, over 270,000 women were discharged from hospitals with a diagnosed arterial hypertension; 34,000 females died from this disease. There were 2.5 million women with heart failure in the United States of America in 2009; each year 320,000 new cases are diagnosed, and over 32,000 women annually die from heart failure (Go et al., 2013). Congenital heart defects are a novel medical challenge. Survival from congenital heart defects had been extremely poor before the introduction of heart surgery in the 1950s. The growing number of survived individuals prognoses that death rate in the adults will grow. In 2009, there were 27,000 women discharged from short-stay hospitals diagnosed with a congenital cardiac defect (Go et al., 2013).
Public Health Impact
The public cardiac disease burden is traditionally described in terms of number and rate of deaths, the number and percentage of the population with a given disease, estimates of economic costs, including direct health care expenditures, and loss of income from early death or disability (Goff et al., 2010). The mortality and morbidity rates are described in this paper elsewhere. The American annual cost of cardiovascular disease to the nation exceeded $351 billion in 2003, which overcomes expenses against cancer $202 and HIV $28.9 (Goff et al., 2010). Thus, this is a major component of health care costs.
The burden can be also explained by personal stories of how cardiac disabilities affect people and their families. 2.6 million female survivors from myocardial infarction feel the impact on their lives after becoming a victim of a heart attack. In addition, there is psychological and financial damage to their spouses, children, parents, and colleagues. For hundreds of thousands of those who did not survive from heart attacks, arterial hypertension, or congestive heart failure, only family members and friends can tell their stories.
Gender Differences in Cardiac Disease
Explanations of gender differences in cardiac diseases are currently under scientific investigation. Anatomy, hormonal influences, physiology, hematologic and electrophysiologic indices are identified (Finks, 2013). Thus, some facts have been studied in detail:
- chest pain is a common symptom of a heart attack. In women, pain is often not severe; sometimes, a heart attack develops without any pains. Women are very likely to complain of neck, jaw, or abdominal discomfort, shortness of breath, sweating, and fatigue. All these lead to misdiagnosis and delays in treatment (Mayo Clinic Staff, 2014);
- women are more likely to experience adverse events (death, re-hospitalization, etc.) during a heart attack (Dey et al., 2011);
- because of womens unique hormonal pattern, atherosclerosis starts at an older age in females. Their sex hormones protect against cardiac diseases until the menopause. The coronary lesions in women differ from those of men (Dey et al., 2011); they experience ischemic heart disease at an older age with worse outcomes;
- the traditional risk factors are somewhat different in women. For example, smoking affects womens hearts more badly than mens. Women who smoke are two times more likely to die of sudden cardiac death as compared to women who do not (Grundtvig et al., 2009). Arterial hypertension during pregnancy may have a negative long-term impact (Mayo Clinic Staff, 2014);
- because diagnosis is often missed or delayed, and cardiac risks are typically expected for males, women are three times less often to receive cardioverter-defibrillator for the prevention of sudden cardiac death (Curtis et al, 2007) and coronary intervention (Go et al., 2013).
Coronary heart disease as well as arterial hypertension and, in many cases, congestive heart failure is a preventable medical problem. If risk factors are timely identified, it is possible to reduce the negative effects of cardiac disease on womens public health. This has been demonstrated by the last decades of the XX century; due to recognition of risk factors of atherosclerosis, the mortality was reduced. However, today, heart disease being the leading cause of mortality and morbidity carries a devastating financial load and thus makes a great public medical problem. A profound understanding of cardiac gender specificity allows physicians to manage the women with cardiac disorders more accurately.