Heart disease prevention not just for boys anymore

Kerri Houston Tolozcko Senior Fellow, Frontiers of Freedom
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Since Congress and the White House passed their unpopular health care bill, consumers who understand the dangers that lurk when government and health care collide are taking a closer look at their own health status.

Women, historically the health care decision makers within the home, often place their own aches and pains last in the health care queue, often with devastating consequences. However, this Spring there is good news for women’s health that could change the history of two devastating diseases.

Recent studies on women’s health concerns revealed that of all diseases women fear, breast cancer is at the top. Most think it is the number one cause of death for their gender. They are wrong.

Heart attack and stroke are the number one and two causes of death for American women, with breast cancer seventh. In 2005, over 41,000 women died of breast cancer, but more than 416,000 succumbed to cardiovascular disease.

Younger women are three times more likely to die from their first heart attack than are men, and more women die every year from cardiovascular disease than their male counterparts.

More women die of stroke every year, and it is the leading cause of disability for women. Women are more than twice as likely to die from a stroke than breast cancer.

Many factors contribute to misconceptions and outcome disparities in regard to women and heart disease. A woman is quicker to take her husband, children, parent, or even her dog to see a doctor than to take herself. Men tend to have “Hollywood heart attacks” with obvious and dramatic symptoms, while indicators for women such as shoulder pain and nausea are difficult to immediately identify as cardiovascular.

Until results of the Framingham Heart Study were released in the 1970s, most people didn’t think women even had heart attacks and their inclusion in clinical trials and treatment studies was virtually non-existent.

But there is significant good news for women in both breast cancer treatment and the prevention of cardiovascular disease: statins for girls.

Statins are drugs that lower “bad” LDL cholesterol in the blood. Although cholesterol is essential in the body, too much clogs arteries with fatty plaque, leading to heart attack, stroke, hypertension, and peripheral artery disease. Long known to effectively lower cholesterol, statins are now also understood to inhibit dangerous inflammation in the cardiovascular system.

In 2008, a national research project called the “Jupiter Study” found that even individuals with “normal” LDL cholesterol levels were at risk for heart attack due to cardiovascular inflammation. In fact, half of all heart attacks occur in people with normal cholesterol levels. Jupiter found that statins not only reduced cardiac events in patients with high LDL, but also reduced cardiac disease in people with normal cholesterol by 44%.

Specifically targeting women’s health, in April 2009 researchers from Georgetown University released a study demonstrating that cholesterol-lowering drugs could have a significant positive effect on breast cancer patients undergoing chemotherapy. Because cholesterol makes cells less permeable by toughening cell walls, high LDL can block the effectiveness of certain treatment drugs, such as Tamoxifen. By reducing cholesterol with statins, membranes become less resistant to the drugs, which can then enter and work their destructive magic on cancer cells.

But a newer finding from the Jupiter Study released in late 2009 is the best news for women yet.

Major cardiovascular incidents in women with some risk factors but no existing coronary disease fell by 46% with the use of statins. Women in the study also experienced a dramatic 76% reduction in the need for expensive and risky vessel clearing procedures like angioplasty or stents.

And based on recent breakthrough studies, last month the FDA approved the use of statins to prevent cardiovascular disease in patients with normal or near-normal cholesterol.

Any medication – from Tamoxifen to Tylenol – can have side effects, and women newly enlightened about bright prospects in their cardiac futures should consult their doctors about whether statins are appropriate for them.

The American Heart Association estimates that 365,000 women could have heart attacks in 2010 – and roughly 20,000 will be diagnosed with breast cancer. Statins offer decreased risk and increased treatment success for each.

When the U.S. Preventative Services Task Force changed guidelines on mammograms last year, American women and physicians were justifiably outraged that the government would suggest un-recommending this life-saving test for women under 40.

As we go forward uncertain of the changes that DemocratCare will bring to America’s health care consumers, the same passion expressed over mammograms needs also to be applied to preventing heart disease in women. There has never been a more pivotal moment in American health care history to advocate for our best health outcomes.

Kerri (Houston) Toloczko is Senior Vice President for Policy at the Institute for Liberty and director of its Center for Healthcare Security and Access.