CVD筛查：筛查人群及工具的确定ppt课件

1、How to Develop a Womens CVD Health Project in Western Countries: Prospects and Actuality The Problem: IncidenceTwo Diseases and Their Toll0 1.25 2.5 3.75 50 5 10 150 40 80 1200 600 1200 180015-2425-4445-6465 andoverAGE(years)RATE PER 100,000HEARTDISEASEBREAST CANCERMortality rates per 100,000 women

2、in the United StatesMore women die of CHD than breast cancer at all agesMurphy SL. Death: final data for 2019. Natl Vital Stat Rep 2000;48:1-105What Can We Do?USA Organizations:NHLBIAHAACCSister to SisterVHA Womens HeartAdvantage ProgramWomenHeartWomens CVD Health ProjectWomens CVD Health ProjectThe

3、 Problem: AwarenessPerception RealityNational Heart, Lung and Blood Institute (NHLBI): The Heart Truth Red DressCollection (2019, 2019, 2019)Women and CVD: Making an ImpactWomens CVD Health ProjectHeart Risk AssessmentCSMC unpublished VHA Womens HeartAdvantage survey dataCVD Risk Assessment National

4、 Day of CVD screening for women started by a woman whose daughter died of heart disease Concurrently held on a weekday across most major US cities Leadership Executive Womens Breakfast to engage involvement, sponsorship and employer support Local medical and corporate sponsors On-site screening and

5、referral donated by healthcare system Healthfare and Expo Screening data are published in the Journal of Womens HealthOn February 27 & 28, 2019, in Century City, the Sister to Sister Foundation, the Los Angeles Lakers, the Century City Chamber of Commerce and Century Park will undertake the extr

6、aordinary task of providing 1,000 free cardiac screenings to women in Los Angeles in memory of the 1,000 women who will be taken by heart disease this month.How Can I Know MyHeart Disease Risk?Visit the Womens HealthWellness booth and sign up for a screening Womens CVD Health Project Nationwide prog

7、ram, locally delivered Lead by “better practice clinicians and hospitals Patient and community centered Customizable for the health care organization or community Measurable Systems oriented Scientifically validTop Five ElementsMortality for Women and Men Post-AMI* and After Adjustment by Risk Score

8、Women have higher CHD mortality*p0.001; p0.002.WomenMen50403020100After adjustment by risk score12243648(%)50403020100Post-AMI12243648(%)ACC/AHA Pocket GuidelinesGender Differences in ED Care for CV Symptoms: Women receive less assessment for CV symptomsMcKinlay JFl, J Health and Social Behavior 201

9、9;37:1Proportional Effects of Treatment Strategies on MortalityAntiplateletBeta BlockerCalcium BlockerFibrinolytics Streptokinase tPA vs. SK ThrombolyticACE Inhibitors00.511.52OR (95% CI)00.511.52OR (95% CI)WomenMenFavors TreatmentFavors ControlFavors TreatmentFavors ControlMI Treatment: Women and M

10、en have similar risk benefitDemographicsLipid Rx at DischargeOverall31.7%Male34.8%Female26.8%Non-Black31.9%Black28.9%Percent of patients discharged on lipid lowering therapyFonarow, Watson, French. Presented ACC 2019; Orlando, FLExample of Myocardial Infarction Automated OrdersGuideline care is deli

11、vered unless physician cancels itOptimizing Physician CVD Management Old Boys Club - 12% of US cardiologists are womenChampions can be men who are interested in qualityWomens CVD Health ProjectNY TimesObstructive CADMore prevalentIn menMicrovascular Coronary DiseaseMore prevalent in womenJACHO AMI C

12、ore Measures Community Awareness & Risk Factor MeasuresProspects for Important Sex-stratifiedResearch Data CollectionJoin the CSMC Womens HealthResearch Registry: Improve WomensHealth for Yourself and Our Daughters Summary: How to Develop a Womens CVD Health Project in Western Countries Media campaigns have raised heart disease awareness among women in the US. “Red Dress campaigns are starting throughout Australia, Europe, South America and Asia. Screening/detection programs have been started aimed at women; d