Regular annual visits to the OB-GYN can be a linchpin to improving women’s heart health, according to an advisory issued Thursday that encourages collaboration with cardiologists and spells out recommendations on how the two can prevent heart disease.
More than 90 percent of women have at least one risk factor for cardiovascular disease. At the same time, most women use their checkups with the obstetrician or annual “well-woman” visits to their gynecologist as their primary point of care, according to the joint advisory(link opens in new window) from the American College of Obstetricians and Gynecologists and the American Heart Association published in Circulation.
That makes those visits “a powerful opportunity to counsel patients about achieving and maintaining a heart-healthy lifestyle, which is a cornerstone of maintaining heart health,” said AHA President Dr. John Warner, an executive vice president at UT Southwestern Medical Center in Dallas.
Traditional risk factors for heart disease – such as high blood pressure, diabetes, high cholesterol and obesity – may affect women differently than men. Regular health milestones like menopause and pregnancy can affect heart health. And preterm delivery and pregnancy complications such as preeclampsia and gestational diabetes can increase cardiovascular risk.
“Pregnancy is essentially a ‘stress test’ for women, and these adverse pregnancy outcomes can be used to identify women who are at an increased risk for [heart disease], even in those for whom the conditions resolve after delivery,” according to the advisory.
So, the visits can be a logical place to talk about weight, nutrition, stress and being active, said Dr. Haywood L. Brown, outgoing president of ACOG and professor of obstetrics and gynecology at Duke University in Durham, North Carolina. He said he first began realizing the need for better coordination and communication more than a decade ago while he chaired the OB-GYN department at Duke. Now, there’s a “new awakening.”
“Many women carry these risk factors for cardiovascular disease, and we should be counseling them on lifestyle modification and further follow-up,” said Brown, a co-author of the advisory. “Many of them don’t see their cardiologist or internist until there is a problem. This partnership is key. It’s about early counseling and early intervention.”
Even with education campaigns and millions spent in advertising and outreach to let the public know that heart disease is the leading cause of death in women, statistics about awareness are worrisome.
Fewer than half – 45 percent – of women know their No. 1 health danger is heart disease, and about 39 percent of primary care physicians ranked it as a top concern, after weight and breast health.
“It’s really concerning to us that maternal mortality has been rising, especially the last 10 years,” said Dr. Lisa Hollier, professor at Baylor College of Medicine in Houston and chief medical officer in obstetrics and gynecology for Texas Children’s Health Plan. She became president of ACOG last week.
“I'm really focusing on reducing preventable maternal mortality and homing in on cardiovascular causes, which account for 25 percent of all” maternal deaths now, she said. “These statistics are really part of the call to action. We know we need to work collaboratively with our partners in medicine to provide the best care for women.”
Developments in software algorithms could potentially analyze electronic medical records and trigger patient education and needed referrals. But any high-tech solution begins with low-tech communication, the doctors said. It’s important to correctly record a patient’s history of disease, risks and pregnancies and share that information between doctors’ offices.
“Working it together and having standardized protocols and enhanced screening processes,” Hollier said, “would help OB-GYNs and cardiologists bridge the information silos and work together for women.”
If you have questions or comments about this story, please email [email protected](link opens in new window)
"Kutembelea mara kwa mara OB-GYN inaweza kuwa kiungo muhimu katika kuboresha afya ya moyo wa wanawake, kulingana na ushauri uliotolewa Alhamisi ambao unahimiza ushirikiano na wataalamu wa moyo na unaelezea mapendekezo juu ya jinsi wawili wanaweza kuzuia ugonjwa wa moyo. """ Zaidi ya asilimia 90 ya wanawake wana angalau moja ya sababu za hatari ya ugonjwa wa moyo. "Wanawake wengi hutumia uchunguzi wao na daktari wa uzazi au ziara za kila mwaka za ""mwanamke mzuri"" kwa daktari wao wa wanawake kama hatua yao ya msingi ya huduma, kulingana na ushauri wa pamoja kutoka Chuo cha Marekani cha Wazazi na Wanawake na Chama cha Moyo cha Amerika kilichochapishwa katika ""Circulation.""" "Hiyo hufanya ziara hizo kuwa fursa nzuri ya kushauri wagonjwa juu ya kufikia na kudumisha mtindo wa maisha wenye afya ya moyo, ambayo ni jiwe la msingi la kudumisha afya ya moyo, ""alisema Rais wa AHA Dk John Warner, makamu wa rais mtendaji katika Kituo cha Matibabu cha UT Southwestern huko Dallas." Sababu za kawaida za hatari ya ugonjwa wa moyo - kama vile shinikizo la juu la damu, kisukari, kolesteroli ya juu na unene wa kupita kiasi - zinaweza kuathiri wanawake tofauti na wanaume. Matukio ya kawaida ya afya kama vile kukoma kwa hedhi na ujauzito yanaweza kuathiri afya ya moyo. Matokeo ya kujifungua kabla ya wakati na matatizo ya ujauzito kama vile preeclampsia na ugonjwa wa kisukari wa mimba yanaweza kuongeza hatari ya ugonjwa wa moyo. "Ujauzito ni ""mtihani wa mkazo"" kwa wanawake, na matokeo haya mabaya ya ujauzito yanaweza kutumika kutambua wanawake ambao wana hatari kubwa ya [ugonjwa wa moyo], hata kwa wale ambao hali hupungua baada ya kujifungua, "kwa mujibu wa ushauri. "Kwa hivyo, ziara zinaweza kuwa mahali pazuri pa kuzungumza juu ya uzito, lishe, mkazo na kuwa hai, ""alisema Dk Haywood L. Brown, rais wa ACOG na profesa wa uzazi na gynecology katika Chuo Kikuu cha Duke huko Durham, North Carolina." "Amesema kuwa alianza kutambua umuhimu wa ""kuunganisha na kuwasiliana vizuri zaidi"" zaidi ya miaka kumi iliyopita wakati alipokuwa akisimamia idara ya OB-GYN katika Chuo Kikuu cha Duke." "Wanawake wengi hubeba sababu hizi za hatari za ugonjwa wa moyo na mishipa ya damu, na tunapaswa kuwapa ushauri juu ya mabadiliko ya mtindo wa maisha na ufuatiliaji zaidi, "alisema Brown, mwandishi mwenza wa ushauri huo." <unk>Wengi wao <unk>haoni daktari wao wa moyo au daktari wa ndani mpaka kuwe na tatizo. Ushirikiano huu ni muhimu. "Hata na kampeni za elimu na mamilioni yaliyotumika katika matangazo na ufikiaji ili kuwajulisha umma kwamba ugonjwa wa moyo ni sababu kuu ya kifo kwa wanawake, takwimu kuhusu ufahamu ni ya wasiwasi. """ Ni chini ya nusu ya wanawake - asilimia 45 - wanajua kwamba hawana. "Ugonjwa wa moyo ni hatari kubwa kwa afya, na asilimia 39 ya madaktari wa matibabu ya msingi waliliweka kama ""hatarini ya kwanza,"" baada ya uzito na afya ya matiti." "Ni jambo la kushangaza sana kwetu kwamba vifo vya akina mama vimeongezeka, hasa katika miaka kumi iliyopita,"" alisema Daktari Lisa Hollier, profesa katika Chuo cha Tiba cha Baylor huko Houston na afisa mkuu wa matibabu katika uzazi na gynecology kwa Texas Watoto 'Huduma ya Afya." Aliwahi kuwa rais wa ACOG wiki iliyopita. "Ninajitahidi kupunguza vifo vya mama vinavyoweza kuepukwa na kuzingatia sababu za moyo, ambazo zinawakilisha asilimia 25 ya vifo vyote vya mama sasa,"" alisema." <unk>Hadithi hizi ni kweli sehemu ya wito wa vitendo. """Tunajua tunahitaji kufanya kazi kwa ushirikiano na washirika wetu katika dawa ili kutoa huduma bora kwa wanawake, maendeleo katika programu ya algorithms inaweza uwezekano wa kuchambua rekodi za matibabu ya elektroniki na kuamsha elimu ya mgonjwa na kuelekeza zinazohitajika." Lakini madaktari walisema kwamba suluhisho lolote la kiteknolojia cha hali ya juu huanza na mawasiliano ya hali ya chini. Ni muhimu kurekodi kwa usahihi historia ya mgonjwa wa ugonjwa, hatari na ujauzito na kushiriki habari hiyo kati ya ofisi za madaktari. "Kufanya kazi pamoja na kuwa na itifaki za kawaida na michakato ya uchunguzi iliyoimarishwa, ""Hollie alisema, ""itawasaidia OB-GYNs na wataalamu wa moyo kuunganisha silos za habari na kufanya kazi pamoja kwa wanawake. ""Ikiwa una maswali au maoni juu ya hadithi hii, tafadhali barua pepe [email protected] (kiungo hufunguliwa katika dirisha jipya)."