Although one of every 2.4 deaths in American women is caused by cardiovascular disease, the majority don’t know it is their leading killer. Stereotypes, lack of education, denial and unhealthy lifestyles have collided to create a perfect storm of looming danger for many women who simply are not aware of their risks.
In the April 2008 issue of MEDSURG Nursing, Shay A. Schroetter and Susan D. Peck stack up the evidence and recent studies on coronary artery disease (CAD) and women, and the data clearly point to an urgent need to take off the blinders. The authors also emphasize that health care providers need to ratchet up the education and counseling they offer women when seeing them in primary care settings.
Schroetter and Peck pinpoint three areas in their research: women’s perceptions about their susceptibility, their actual risk factors and their perceived barriers to heart-healthy behaviors. The authors found most women think breast cancer poses their greatest risk of death, and assume that heart disease aims its arrow mostly at overweight, stressed out men who smoke. Second, women are poorly informed about the major risk factors, namely hypertension, hyperlipidemia, diabetes, smoking, obesity and lack of exercise. Last, the research shows, women tend to put others’ needs before their own health care.
Solutions to making women aware lie with public programs, such as the “Go Red for Women” campaign conducted by the American Heart Association, more heart-healthy education provided by nurses and action by physicians and other health care providers to include more intensive heart-related assessments into primary care, the authors say.
Women’s Risk of Heart Disease: Promoting Awareness and Prevention – A Primary Care Approach
Shay A. Schroetter, MSN, RN, CNP, and Susan D. Peck, PhD, RN, GNP-BC, CHTP, CHt
MEDSURG Nursing April 2008 – http://www.medsurgnurse.org
About MEDSURG Nursing – The Journal of Adult Health
MEDSURG Nursing, The Journal of Adult Health, is the official journal of the Academy of Medical-Surgical Nurses (AMSN). The journal provides its readers with the multidisciplinary information they need to provide clinically excellent patient care and to enhance their nursing practice. MEDSURG Nursing supports adult health/medical-surgical nurses as they strive for excellence in patient care, private practice, and outpatient health care settings in urban, suburban, and rural locations. Each peer-reviewed issue of MEDSURG Nursing features a comprehensive discussion and description of today’s clinical issues in adult health/medical-surgical nursing. MEDSURG Nursing and AMSN are committed to the advancement of adult health/medical-surgical nursing practice. The journal is published six times a year.
MEDSURG Nursing
Medical specialists from
around the country will gather this week to discuss the latest research in
obstetrics and gynecology, and menopause and estrogen therapy will be among
the information presented.
“Estrogen therapy continues to be the gold standard for the management
of hot flashes, the most common physical sign of menopause,” said Dr. Ricki
Pollycove, fellow, American College of Obstetrics and Gynecology and
clinical faculty member, University of California, San Francisco. “However,
because of misconceptions that still exist today due to the influx of
conflicting information that has emerged since the Women’s Health
Initiative Study, women may not be aware that advances in low-dose hormone
therapies exist.”
In June 2007, the U.S. Food and Drug Administration (FDA) approved
Divigel(R) (estradiol gel) 0.1 percent, the lowest approved dose of
estradiol available for the treatment of moderate to severe hot flashes
associated with menopause. Guidelines from the North American Menopause
Society (NAMS) indicate that estrogen hormone therapy should be used at the
lowest effective dose for the shortest amount of time.
“Transdermal estrogen therapies, such as Divigel(R), are emerging as an
effective and safe mode of treatment,” said Dr. Pollycove.
The estrogen in Divigel(R) is derived from plant sources and is
bioidentical to the primary estrogen produced by a woman’s ovaries before
menopause. Certain older oral estrogen therapies contain conjugated
estrogens derived from the urine of pregnant mares. Divigel(R) is a
quick-drying gel that is odorless when dry, and is available in convenient,
individual-use packets. One packet of gel is applied daily to an area that
measures approximately 5 x 7 inches on the thigh, the smallest application
area compared to all other available gel or lotion estrogen products. After
the gel is applied, it absorbs directly into the bloodstream without having
to pass through the liver. Divigel(R) also offers dosing flexibility with
three different strengths (0.25 mg estradiol/day, 0.5 mg estradiol/day and
1.0 mg estradiol/day) to individualize treatment for each woman.
Important Safety Information for Patients
The following are not all the possible risks for Divigel(R). Please
read the full Patient Information leaflet and talk to your healthcare
provider.
Estrogens increase the chance of getting cancer of the uterus. Report
any unusual vaginal bleeding right away while you are taking estrogens.
Vaginal bleeding after menopause may be a warning sign of cancer of the
uterus (womb). Your healthcare provider should check any unusual vaginal
bleeding to find out the cause. In general, the addition of a progestin is
recommended for women with a uterus to reduce the chance of getting cancer
of the uterus.
Do not use estrogens, with or without progestins, to prevent heart
disease, heart attacks, or strokes. Using estrogens, with or without
progestins, may increase your chance of getting heart attacks, strokes,
breast cancer, and blood clots.
Do not use estrogens, with or without progestins, to prevent dementia.
Using estrogens, with or without progestins, may increase your risk of
dementia.
Do not use estrogen products, including Divigel(R), if you have unusual
vaginal bleeding, currently have or have had certain cancers, had a stroke
or heart attack in the past year, currently have or have had blood clots,
currently have or have had liver problems, are allergic to any Divigel(R)
ingredients, or think you may be pregnant.
The most common side effects for all estrogen products are headache,
breast pain, irregular vaginal bleeding or spotting, stomach/abdominal
cramps and bloating, nausea and vomiting, and hair loss. Less common but
serious side effects include breast cancer, cancer of the uterus, stroke,
heart attack, blood clots, dementia, gallbladder disease and ovarian
cancer.
In Divigel(R) clinical trials, the most common side effects were
inflammation of the nasal passages and pharynx, upper respiratory tract
infection, vaginal yeast infection, breast tenderness and vaginal bleeding.
Call your healthcare provider right away if you have any symptoms that
concern you.
Estrogen products should be used at the lowest dose possible for your
treatment and only as long as needed. You and your healthcare provider
should talk regularly about whether you still need treatment with
Divigel(R).
Orion Corporation (OMX: ORNAV, ORNBV) has a licensing agreement with
Upsher-Smith Laboratories for the development of Divigel(R) in the United
States. Orion is one of the leading pharmaceutical companies in northern
Europe through its development, manufacturing and marketing of
pharmaceuticals, active pharmaceutical ingredients and diagnostic tests for
global markets. The core therapeutic areas in Orion’s product and research
strategy are central nervous system disorders, cardiology, critical care
and hormonal and urological therapies.
Upsher-Smith Laboratories, Inc. is a rapidly growing pharmaceutical
company that manufactures and markets both prescription and consumer
products. Privately held since 1919, the company strives to recognize the
unmet healthcare needs of our customers. Upsher-Smith prides itself in
providing safe, effective, and economical therapies to the ever-challenged
healthcare environment. For additional information about Upsher-Smith,
visit http://www.upsher-smith.com.
Upsher-Smith Laboratories, Inc.
http://www.upsher-smith.com
Low-income Hispanic Women Buy, Eat More Healthy Foods Than Low-Income Blacks, Whites, Study Finds
May 5, 2008
Low-income Hispanic women are more likely than their black and white counterparts to follow diets that are rich in fruits and vegetables, according to a study published in the Journal of the American Dietetic Association, Reuters Health reports. The study, led by researcher Sharon Hoerr, a professor of food science and nutrition at Michigan State University, looked at 603 low-income mothers who participate in Head Start programs in Alabama and Texas.
Researchers found that while diets among all women in the study tended to be low in important nutrients, Hispanic women in general consumed more fruits and vegetables than blacks and whites. Hispanic women consumed 4.6 cups of fruits and vegetables daily — which health experts considered an adequate amount — while black and white women consumed an average of two to three cups daily. Hispanic women also consumed a lower percentage of daily calories from fat.
According to Reuters, the Hispanic women likely followed a traditional Hispanic diet, which includes more beans, grains and produce than the typical U.S. diet.
Hoerr said that Hispanic women likely “prioritized” fruits and vegetables when they shopped and budgeted. She said the study “refutes the idea that it’s impossible” to eat healthy foods on a small budget, adding that low-income families should be taught methods for securing low-cost nutritious food items, such as shopping at farmers’ markets or choosing canned or frozen vegetables rather than fresh (Norton, Reuters Health, 5/1).
Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.
© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2008 The Advisory Board Company. All rights reserved.
Rapid population growth in Uganda is undermining efforts to fight the spread of HIV/AIDS, Uganda AIDS Commission Director General Kihumuro Apuuli said Wednesday at a press briefing in the capital of Kampala, New Vision/Allafrica.com reports. Apuuli spoke with journalists ahead of the four-day HIV/AIDS global implementers meeting scheduled to start June 3 in Kampala.
There are an estimated 30 million people living in Uganda, New Vision/Allafrica.com reports. Apuuli said about 1.1 million of them are HIV-positive, but 90% are not aware that they are living with the disease. He also noted that more than 30,000 new HIV cases occur there annually. In addition, HIV-related deaths had increased 30% to 100,000 last year from 72,000 a few years ago, when a national survey was conducted.
According to Apuuli, mother-to-child HIV transmission accounts for 22% of new HIV cases in Uganda, and 25% of infants born to HIV-positive women contract the virus. Women in Uganda have an average of seven children, according to New Vision/Allafrica.com. Apuuli said that people often engage in risky behavior under the assumption that new medications to treat HIV/AIDS will soon be available. “If we do not prevent new infections, we will be chasing a mirage,” he said.
The country’s AIDS commission has created a five-year plan that focuses on HIV prevention, according to Apuuli. He added, “There are 120,000 people on antiretroviral drugs out of an estimated 240,000 who need it. We intend to make the drugs available to 300,000 people” (Mugisa, New Vision/Allafrica.com, 4/30).
Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.
© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
“We can no longer be silent” about the rising sexually transmitted infection rates in the U.S., particularly in the black community, Rep. Stephanie Tubbs Jones (D-Ohio) writes in a Seattle Medium opinion piece, noting the findings of a recent study that found that one in four teenage girls has an STI. The study also found that about 50% of young black women, compared with 20% of young white women, have an STI, Jones writes.
“These infections can lead to long-term health risks including chronic pain, infertility, tubal pregnancies and cervical cancer,” Jones writes, adding that STIs also “often carry with them a stigma and feelings of shame for patients and leads to long-term emotional suffering and stress for families.” Jones says that the “abstinence-only education [policy] touted by the Bush administration is simply not enough” and that more candid conversations about the risks of having unprotected sex are needed.
In light of the study’s findings, Jones, along with 60 other lawmakers of both parties, has introduced a resolution “urging the House of Representatives to focus greater attention on activities related to the prevention, screening and treatment” of STIs, she writes. She adds that the resolution “supports the goals of National STD Awareness Month by encouraging the federal government … to provide additional funding for screening and treatment services and requests increased programming and activities to educate Americans of all ages on the risks and prevention” of STIs.
Jones continues, “Additionally, we need to begin discussing the issue of [STIs] in our schools, churches and homes in order to stem the tide of this growing problem,” concluding, “We must take action on this issue before it’s too late” (Jones, Seattle Medium, 4/30).
Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.
© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Women Catching Up With Men In Alcoholism
May 5, 2008
* A new examination of data on similarly aged groups, compared across decades, has found substantial increases in drinking and alcohol dependence among women.
* Increases were particularly notable among white and Hispanic women – beginning with those born in the United States after World War II.
Cross-sectional studies, which collect information at a single point in time, generally find that young Americans report having more lifetime alcohol problems than older Americans, despite having had less time to develop these problems. But these studies are hampered by the fact that people of different ages may remember or report problems to different degrees. A new examination of data, collected on similarly aged groups one decade apart, has found substantial increases in drinking and alcohol dependence among women – particularly white and Hispanic women – beginning with those born in the United States after World War II.
Results are published in the May issue of Alcoholism: Clinical & Experimental Research.
“By looking at two different cross-sectional surveys that asked the same questions in the same manner, but were conducted 10 years apart, we were able to compare, for example, 30 – 40 year olds in 2001 with 30 – 40 year olds in 1991,” explained Richard A. Grucza, an epidemiologist at Washington University School of Medicine and the study’s corresponding author. “Essentially, this allowed us to correct for the effects of age on reporting. When we did this, we found that the tendency for young people to have higher levels of lifetime alcohol dependence clearly remained for women, although it disappeared for men.”
Furthermore, added Shelly F. Greenfield, associate clinical director of the Alcohol and Drug Abuse Treatment Program at McLean Hospital, prevalence surveys are inclusive. “Epidemiologic surveys document the prevalence of an illness such as alcohol dependence in the entire population rather than just one segment of the population, such as those seeking treatment,” she said. “This allows us to track trends in illnesses – including whether certain people are more vulnerable for a particular disease, at what age they manifest symptoms, and how quickly the illness progresses.”
For this study, researchers examined two large, national surveys: the National Longitudinal Alcohol Epidemiologic Survey (NLAES), conducted in 1991 and 1992; and the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), conducted in 2001 and 2002. They compared lifetime prevalence rates from the same age groups and demographics, while simultaneously controlling for age-related factors.
“We found that for women born after World War II, there are lower levels of abstaining from alcohol, and higher levels of alcohol dependence, even when looking only at women who drank,” said Grucza. “However, we didn’t see any significant tendency for more recently born men to have lower levels of abstention, or higher levels of alcohol dependence.” He added that these results shed more light on a “closing gender-gap in alcoholism,” showing that it is probably due to higher levels of problems among women, while men have been more or less steady in their levels of dependence.
Greenfield concurred. “This is an excellent study that adds important information to the accumulating evidence that the gender gap between women and men in the prevalence of alcohol dependence is narrowing,” she said. “One possible explanation is that between 1934 and 1964, the social acceptability of women’s drinking increased. As it was more socially acceptable for women to drink, a greater number of them became drinkers. Because women have a heightened vulnerability to the effects of alcohol – that is, greater blood alcohol levels at similar ‘doses’ of alcohol – we may therefore see a concomitant rise in alcohol dependence among those who ever drank.”
Grucza drew an analogy between women’s drinking habits and culture and immigration. “Clearly there were many changes in the cultural environment for women born in the 40s, 50s and 60s compared to women born earlier,” he said. “Women entered the work force, were more likely to go to college, were less hampered by gender stereotypes, and had more purchasing power. They were freer to engage in a range of behaviors that were culturally or practically off-limits, and these behaviors probably would have included excessive drinking and alcohol problems.”
He noted that U.S. immigrants from cultures with conservative values vis-à-vis drinking tend to adhere to their own cultural norms, while their children are likely to adopt U.S. norms, which are comparatively lax regarding alcohol.
“We can think of U.S. culture as having been traditionally dominated by white men,” added Grucza. “As women have ‘immigrated’ into this culture, they have become ‘acculturated’ with regard to alcohol use. But Black women – who still have the lowest rates of drinking among the demographic groups we looked at – have a second barrier between them and the dominant U.S. culture, namely, their race, that may be keeping them from adopting the standards of the dominant culture with respect to alcohol use.”
Greenfield suggested that specially designed prevention programs that target female drinkers might help to lower drinking rates, and also delay the age of drinking initiation, which could help prevent later alcohol problems. “It would also be helpful to educate women about the gender differences in metabolism of alcohol, and the associated heightened female vulnerability to alcohol’s adverse health consequences at lower doses than men,” she said.
Grucza agreed that interventions for women need further investigation. “Whenever we see change in a disorder in the population, there is an opportunity to take a closer look at which risk factors for the disorder might be changing at the same time,” he said. “The classic example of this would be the rise in lung cancer in the late 20th century, a time in which sales of commercially produced cigarettes also skyrocketed. In this case, we obviously wouldn’t want to change the progress made by women over the last 50 – 60 years, but we can look at specific changes in their drinking behavior and start to speculate about what interventions might work.”
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Article adapted by Medical News Today from original press release.
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Alcoholism: Clinical & Experimental Research. (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, “Secular Trends in the Lifetime Prevalence of Alcohol Dependence in the United States: A Re-Evaluation,” were: Kathleen K. Bucholz, John P. Rice, and Laura J. Bierut of the Department of Psychiatry at the Washington University School of Medicine in St. Louis, Missouri. The study was funded by the National Institutes of Health.
Source:
Richard A. Grucza, Ph.D.
Washington University School of Medicine
Shelly F. Greenfield, M.D., M.P.H.
Harvard Medical School
Alcoholism: Clinical & Experimental Research
Many women under age 55 aren’t seeking timely treatment for heart attack because they expect the warning signs and their reaction to follow a Hollywood script – tightening in the chest, shortness of breath, clutching the chest while dropping to one knee.
That’s the finding of researchers who presented their study at the American Heart Association’s 9th Scientific Forum on Quality of Care and Outcomes Research (QCOR) in Cardiovascular Disease and Stroke.
Researchers studied 30 women who had suffered a heart attack (average age 48). The young women were allowed to talk about their experiences in great detail, using their own words to describe their recognition of symptoms, their initial actions (or lack of action), and their reasons for not seeking prompt care.
“We found that most failed to connect their symptoms with a heart condition, commonly misattributing them to fatigue, indigestion, stress or overexertion,” said Judith Lichtman, Ph.D., lead author of the study and associate professor of epidemiology and public health at the Yale School of Medicine in New Haven, Conn.
Researchers conducted in-depth telephone interviews with the women within seven days of their hospital discharges for heart attacks between October 2006 and May 2007. The interviews explored the women’s initial recognition and response to symptoms, their healthcare beliefs and their acute healthcare experiences. Lichtman said the interviews lasted roughly 30 to 40 minutes, and the more open-ended format allowed the young women to describe their experiences in detail.
“The stories they told were incredibly rich in detail,” Lichtman said. “We learned that many of these women had no idea that they were at risk for heart disease and were unaware that their symptoms could be connected with a heart problem, citing the lack of good examples in the public media to help them recognize atypical symptoms, or realize that someone their age could even be at risk for a heart problem. We also learned much more about their experiences with the healthcare system in terms of preventive care and the care they received during the acute presentation.”
Lichtman noted many of the women were surprised that their actual symptoms differed from the ‘Hollywood heart attack’ that they would have expected. “They wish that they had known that symptoms such as neck and shoulder pain, abdominal discomfort that was easy to mistake for indigestion, or unusual fatigue could signal a heart problem,” she said. “They often said that TV doesn’t show examples of the symptoms they experienced. If they knew, they would have responded to the symptoms sooner.”
The participants described a complex internal dialogue as they decided when to engage the healthcare system and identified an array of factors that contributed to delays, ranging from:
- Uncertainty
- Preference to self-medicate
- Perceived negative treatment by healthcare providers
- Competing time/family demands
- Individual beliefs and behaviors to health system failures
- Seeking corroboration of symptoms and deferring responsibility to engage the healthcare system
Many of the women said they didn’t receive prompt care for their symptoms because they called their physician and were given an appointment within a few days. Some of those who went to the emergency room said they experienced long delays there because they were thought to have non-cardiac conditions.
“While this was certainly not the experience for all women, repeated stories of being triaged to less urgent care initially for what were thought to be non-cardiac conditions suggest that additional work is needed to help young women, their families and healthcare providers recognize that young women with heart disease may present with typical and atypical symptoms,” Lichtman said. “There are large gaps in our understanding of the symptoms young women experience or reasons they delay seeking prompt care. It is important to help young women recognize that they can be at risk for heart disease despite the fact that we often associate heart disease with older patients.
“Although young women represent less than 5 percent of all patients with heart disease, this is significant because it still translates to 16,000 deaths and about 40,000 hospitalizations annually – a number that rivals breast cancer in this age group. Because heart disease is less common at this younger age, current media campaigns and prevention messages do not appear to be reaching this group.”
This study builds on findings from a prior pilot study of 24 women (age 55 and younger) presented at the 2007 QCOR meeting. In that study the researchers found that more than half of the women who experienced heart attack symptoms delayed seeking care for more than an hour.
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Article adapted by Medical News Today from original press release.
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The Fannie E. Rippel Foundation funded the current study. The prior pilot study was funded by the American Heart Association Heritage Affiliate.
Co-authors are: Emi Watanabe, M.P.H.; Norrina Allen, M.P.H.; Brian Garavalia, Ph.D.; Linda Garavalia, Ph.D.; Carole Decker R.N., Ph.D.; John Spertus, M.D., M.P.H.; Harlan M. Krumholz, M.D., S.M.; and Leslie Curry, Ph.D., M.P.H.
Heart disease is the #1 killer of women and claims more than 460,000 women’s lives per year – that’s about one death per minute. Because heart disease is largely preventable, the American Heart Association’s Go Red For Women movement urges women to take action and reduce their personal risk. Visit GoRedForWomen.org to take the Go Red Heart CheckUp and receive a 10-year risk assessment and personalized action plan.
Statements and conclusions of abstract authors presented at American Heart Association/American Stroke Association scientific meetings are solely those of the abstract authors and do not necessarily reflect association policy or position. The association makes no representation or warranty as to their accuracy or reliability.
NR08-1054 (QCOR 08/Lichtman)
Abstract 197
Source: Karen Astle
American Heart Association
Women with fibroids and endometriosis facing the possibility of hysterectomy may now choose less invasive treatment options to preserve fertility, according to Yale professor Aydin Arici, M.D., isn directing a scientific session exploring these alternatives at the American College of Obstetricians and Gynecologists (ACOG) Annual Clinical Meeting May 3-7 in New Orleans, Louisiana.
Arici will chair the two-day postgraduate ACOG course “Current Topics in Reproductive Endocrinology for the Clinician.” He joins colleagues in the Yale Department of Obstetrics, Gynecology & Reproductive Sciences as they lead other ACOG courses on menopause, managing post-term pregnancy, and managing patients with bleeding disorders during pregnancy.
In his course, Arici will present treatment options for endometriosis and share novel conservative approaches for treating fibroids, the most common benign tumor seen in reproductive-age women and the leading cause of hysterectomy in the United States.
“Our goal is to educate general obstetricians on ways to tailor new treatment techniques to the needs of individual patients,” said Arici. “For women in their 30s and 40s, preserving reproductive potential while treating fibroids is often desired. In the past, ovarian function was suppressed by inducing sudden menopause to shrink fibroids. Novel medications that were unavailable a few years back are now able to do so without unpleasant side effects.”
Arici said that conservative treatment options include a medical approach using selective estrogen receptor modulators and selective progesterone receptor modulators, uterine artery embolization, MRI-focused high-energy ultrasound, and conservative surgery using abdominal myomectomy, hysterectomy to remove the fibroids, but preserve the reproductive capacity of the uterus.
Yale Ob/Gyn reproductive endocrinologist Lubna Pal’s ACOG course will explore the biological, psychosocial and behavioral consequences of women’s transition into menopause and the postmenopausal years. One of her goals is to help doctors understand the predictors of menopause, and the treatment needs of women who have undergone hysterectomies or oophorectomies.
Errol Norwitz, M.D., will lead an interactive session on managing post-term or overdue pregnancies. He and his colleague will address issues such as the risks and benefits of routine induction of labor at 41 weeks gestation.
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Article adapted by Medical News Today from original press release.
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Chair of Yale Ob/Gyn Charles Lockwood, M.D., and Associate Professor Michael Paidas, M.D., will lead an interactive session on bleeding disorders during pregnancy.
Other current and former Yale faculty members teaching courses at ACOG include Susan Richman, Steven Fleischman, Rebecca Pschirrer, John Hobbins, Al Reece, Monique Chireau, Robert Graeve, John Larsen, Thomas Moore, Donald Coustan and Alessandro Ghidini.
Source: Karen N. Peart
Yale University
Coronary heart disease mortality in younger women could be on the rise, according to findings in the open access journal, BMC Public Health, published by BioMed Central. High levels of smoking, increasing obesity and a lack of exercise could all be contributing to this disturbing trend, seen in women under the age of 50.
Coronary heart disease (CHD) is the most common cause of death in the UK, the US, Canada and Australia. It occurs when the arteries supplying blood to the heart narrow, and includes disorders such as heart attacks and angina.
Steven Allender from the University of Oxford and colleagues from the University of Liverpool, UK studied information on all deaths in England and Wales between 1931 and 2005. They examined how CHD mortality rates had changed over time, for different sexes and age groups.
They found that CHD mortality rates in England and Wales rose steadily throughout the 20th century and peaked in the 1970s. In most groups, the rate of CHD mortality has been falling steadily since then. Recent generations have experienced much lower CHD mortality rates than those born in the late 19th or early 20th centuries.
Despite this, researchers have detected a levelling off and perhaps even a reversal of the rate of decline in CHD mortality in women under 50. Given that CHD causes over 100,000 deaths in the UK each year, such a trend would have serious implications for health-care provision in the future.
The authors also found evidence that significant advances made in terms of CHD mortality among older populations are not being made in the under-60s something they warn could increase the burden of CHD if left unchecked.
“We observed that CHD mortality among younger age groups has increased in those born in the early twentieth century compared to those born in the late 19th century” notes Allender. “This requires further study as the public health implications of a decline in survival from CHD in younger age groups may be stark.”
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