Ethnic groups and sociodemographic, economic and cultural conditions influence management, according to the guide.
Las ethnicities and the sociodemographic conditions, economic and cultural so diverse that occur in Latin America “can lead to the need for different approaches to cardiovascular diseases.” This is how the cardiologist explains it Cecilia Bahit and main author of clinical practice guideline from Interamerican Society of Cardiology (SIAC) on the primary prevention of cardiovascular disease in women. According to the specialist, “the Latin American women have a higher attributable risk for acute myocardial infarction than women in the rest of the world”. For this reason, this new document establishes 15 strategic lines to alleviate this problem.
The three characteristics that should be addressed as a priority are the following: “The family history of premature heart diseaseespecially to take it into account in adults with low or intermediate risk in the stratification of cardiovascular risk; dyslipenias, before which it is recommended to control associated cardiovascular risk factors and lifestyle changes, screen lipids and lipoproteins; Y determine the risk of suffering this pathology in women“.
These are followed by the following strategic lines to alleviate and try to reduce the prevalence of cardiovascular disease in women:
- Overweight and obesity: Maintain a healthy weight with a body mass index of 18.5 to 24.9 kg/m2 and a waist circumference of less than 88 cm in women. The increased cardiovascular risk, diabetes, mortality and decreased life expectancy of women with obesity should also be transmitted at every opportunity.
- Physical activity: In the case of girls, adolescents and young people, it is recommended to perform 60 minutes of moderate to vigorous intensity aerobic physical activity daily, incorporating resistance and strengthening exercises at least three days a week. In pregnantaccomplish moderate-intensity physical activity, at least 150 minutes per week. In adult and older women, perform 150 to 300 minutes of moderate-intensity physical activity per week.
- smoking: Tobacco consumption or exposure to tobacco smoke must be included in each medical consultation and the status of smoker must be recorded. Likewise, female smokers should be emphatically recommended to give up the habit, and all female smokers should also be recommended to treatment combining cognitive-behavioral strategies and pharmacotherapy.
- Arterial hypertension: In young, premenopausal women with hypertension, causes of secondary arterial hypertension should be investigated, choosing the appropriate drug for the finding.
- Psychosocial factors, stress and depression: Research of psychosocial factors, stress and depression should be carried out in women in primary prevention of cardiovascular disease to correctly stratify cardiovascular risk.
- Autoimmune diseases: Women with autoimmune disease have a high risk of cardiovascular disease and reduced life expectancy, so evaluation of cardiovascular risk and intensive control of cardiovascular risk factors is recommended.
Other recommendations of the SIAC guide
Along with all of these, Bahit also states that “the cardio-oncology The oncological history and the type of treatment received should be included in the anamnesis to evaluate the patient’s risk profile”. In this regard, the cardiologist explains that the guide also sets the “menopause as another of the recommendations to take into account to treat cardiovascular disease, since it is necessary to investigate the gynecological history of the patientsincluding age at menarche, during screening for cardiovascular risk factors”.
The premature ovarian failure, menopause and hormonal therapy, and polycystic ovary syndrome are two other points included in the SIAC guide. Regarding the first, Bahit details that “it is recommended to investigate, in the first consultation, the gynecological and obstetric history, including the age of onset of menopause to determine the presence of premature ovarian insufficiency or early menopause.”
As for polycystic ovary syndrome, the cardiologist calls “all those women in childbearing age with overweight or obesity so that they are subjected to studies and thus rule out this pathology”. And, finally, Bahit adds three more recommendations to address the cardiovascular disease in women: “Disorders associated with pregnancy and non-pharmacological and pharmacological measures in primary prevention”, he concludes.
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