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The Big Heart Disease Lie

Cardiovascular Disease is Curable

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Fig. 1. Cardiovascular morbidity and mortality in women. (A) There has been a significant decline in cardiovascular mortality for men from 1979-1998, yet an increase in women for the same time period. (B) Women age 65 yr or older are more likely to have a myocardial infarction than younger women (1). MIs, myocardial infarctions; yr, years.

Fig. 1. Cardiovascular morbidity and mortality in women. (A) There has been a significant decline in cardiovascular mortality for men from 1979-1998, yet an increase in women for the same time period. (B) Women age 65 yr or older are more likely to have a myocardial infarction than younger women (1). MIs, myocardial infarctions; yr, years.

time risk of developing coronary heart disease after age 40 is 49% for men and only 32% for women, women are more likely to experience significant morbidity and mortality associated with an acute coronary syndrome (1). Interestingly, while mortality rates have declined over time for men, they have increased for women (Fig. 1). In part, because women have myocardial infarctions at older ages than men, they are more likely to die following the event, and mortality usually occurs within a few weeks (Fig. 1). In fact, 38% of women, compared to 25% of men, will die within 1 yr after having an initial recognized myocardial infarction, and by 6 yr after the index event, 35% of women will have a second acute coronary syndrome compared to only 18% of men (1). African-American women are at particularly high risk for adverse outcomes associated with acute coronary syndromes as evidenced by mortality data from 1998 that revealed that deaths from cardiovascular disease occurred in 400.7/1000 for black females compared to 294.9/1000 for white females (1).

Cardiovascular disease has been recognized as the leading cause of morbidity and mortality in women since the early 1900s, accounting for the death of 53% of women compared to 47% of men in the United States in 1998. Recent data from the Nurses' Health Study revealed a 31% decrease in coronary artery disease incidence in this cohort of women from the 2-yr period 1980-1982 to the 2-yr period 1992-1994; however, the rates of decline have been slower in women compared to men and the risk of death, rein-farction, and congestive heart failure following a nonfatal myocardial infarction remained higher in women than in men (1,2).

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