Future heart attacks are prevented by the prevention of atherosclerosis or plaque formation in the coronary arteries and by the stabilization and regression of existing plaque through lifestyle modification and medication. Coronary bypass surgery and angioplasty with stent placement do not prevent future heart attacks in patients with chronic CHD. These procedures only relieve ischemia in the distribution of established stenoses. All women must take personal preventive action to prevent CHD death and disability by working to prevent plaque formation and promote stabilization of existing atherosclerotic disease. This is the basis of CHD prevention in women.
1 American Heart Association. 2002 Heart and Stroke Statistical Update. Dallas: American Heart Association; 2001.
2 European Heart Network. www.ehnheart.org/statistics/summary. Accessed September 23, 2002.
3 Verma, S. and Anderson, T. J. Fundamentals of endothelial function for the clinical cardiologist. Circulation 2002; 105:546-9.
4 Lerner, D. J. and Kannel, W. B. Patterns of coronary heart disease morbidity and mortality in the sexes: a 26-year follow-up of the Framingham population. Am. Heart J. 1986; 111:383-90.
5 Rich-Edwards, J. W., Manson, J. E., Hennekens, C.H and Buring, J. E. The primary prevention of coronary heart disease in women. N. Engl. J. Med. 1995; 332: 1758-66.
6 Grundy, S. M., Pasternak, R., Greenland, P., et al. Assessment of cardiovascular risk by use of multiple risk factor equations: a statement for healthcare professionals from the American Heart Association and the American College of Cardiology. J.Am. Coll. Cardiol. 1999; 34:1348-59.
7 Wilson, P. W. F., D'Agostino, R. B., Levy, D., et al. Prediction of coronary risks using risk factor categories. Circulation 1998; 97:1837-47.
8 www.statcoder.com. Accessed September 23, 2002.
9 www.nhlbi.nih.gov/health/public/heart/other/hhw/index.htm. Accessed September 23, 2002.
10 Willett, W. C., Green, A., Stampfer, M. J., et al. Relative and absolute excess risk of coronary heart disease among women who smoke cigarettes. N. Engl. J. Med. 1987; 317:1303-9.
12 Mosca, L., Grundy, S., Judelson, D., etal. Guide to preventive cardiology for women. AHA/ACC Scientific statement: consensus panel statement. J. Am. Coll. Cardiol. 1999; 33:1751-5.
13 The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Arch. Intern. Med. 1997; 157:2413-46.
14 Moser, M., Hebert, P. and Hennekens, C. H. An overview of the meta-analyses of the hypertension treatment trials. Arch. Intern. Med. 1991; 151:1277-9.
15 Labarthe, D. and Ayala, C. Non-drug interventions in hypertension prevention and control. Cardiol. Clin. 2002; 20:249-63.
16 Grundy, S. M., Howard, B., Smith, S., et al. Prevention conference VI: diabetes and cardiovascular disease. Executive summary. Conference proceeding for healthcare professionals from a special writing group of the American Heart Association. Circulation 2002; 105:2231-9.
17 Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). J. Am. Med. Assoc. 2001; 285:2486-97.
18 Ford, E. S., Giles, W. H. and Dietz, W. H. Prevalence of the metabolic syndrome among U.S. adults: findings from the third National Health and Nutrition Survey. J. Am. Med. Assoc. 2002; 287:356-9.
19 Lemaitre, R.N., Psaty, B.M., Heckbert, S. R., et al. Therapy with hydroxymethyl-glutaryl coenzyme A reductase inhibitors (statins) and associated risk of incident cardiovascular events in older adults - evidence from the cardiovascular health study. Arch. Intern. Med. 2002; 162:1395-400.
20 Downs, J. R., Clearfield, M., Weis, S., et al. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS. J. Am. Med. Assoc. 1998; 279:1615-22.
21 Sacks, F. M., Pfeffer, M. A., Moye, L. A., et al. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels: cholesterol and recurrent events trial investigators. N. Engl. J. Med. 1996; 335:1001-9.
22 Packard, C.J. Influence of pravastatin and plasma lipids on clinical events in the West of Scotland Coronary Prevention Study (WOSCOPS). Circulation 1998; 87: 1440-45.
23 LaRosa, J. C., He, J. and Vupputuri, S. Effect of statins on the risk of coronary disease: a meta-analysis of randomized controlled trials. J. Am. Med. Assoc. 1999; 282:2340-46.
24 Yeung, A. C. and Tsao, P. Statin therapy: beyond cholesterol lowering and anti-inflammatory effects. Circulation 2002; 105:2937-38.
25 Pasternak, R. C., Smith, S. C., Jr, Bairey-Merz, C. N., et al. ACC/AHA/NHLBI advisory on the use and safety of statins. J. Am. Coll. Cardiol. 2002; 40:567-72.
26 Field, A. E., Coakley, E. H., Must, A., et al. Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch. Intern. Med. 2001; 161:1581-6.
27 Manson, J. E., Stampfer, M. J., Colditz, G. A., et al. A prospective study of obesity and the risk of coronary heart disease in women. N. Engl. J. Med. 1990; 322:882-9.
28 Eckel, R. H. Obesity and heart disease: a statement for healthcare professionals from the Nutrition Committee, American Heart Association. Circulation 1997; 96:324850.
29 Bjorntorp, P. Regional patterns of fat distribution. Ann. Intern. Med. 1985; 103: 994-5.
30 Lemaitre, R. N., Heckbert, S. R., Psaty, B. M. and Siscovick, D. S. Leisure-time physical activity and the risk of nonfatal myocardial infarction in postmenopausal women. Arch. Intern. Med. 1995; 155:2302-8.
31 Kushi, L. H., Fee, R.M., Folsom, A. R., et al. Physical activity and mortality in postmenopausal women. J. Am. Med. Assoc. 1997; 277:1287-92.
32 Fletcher, G. F., Balady, G., Blair, S.N., et al. Statement on exercise: benefits and recommendations for physical activity programs for all Americans. A statement for healthcare professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association. Circulation 1996; 94:857-62.
33 Physical activity and cardiovascular health. NIH Consensus Development Panel on Physical Activity and Cardiovascular Health. J. Am. Med. Assoc. 1996; 276:241-6.
34 US Department of Health and Human Services. Physical Activity and Health: A Report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Public Health Service, CDC, National Center for Chronic Disease Prevention and Health Promotion; 1996.
35 Manson, J. E., Stampfer, M. J., Colditz, G. A., et al. A prospective study of aspirin use and primary prevention of cardiovascular disease in women. J. Am. Med. Assoc. 1991; 266:521-7.
36 US Preventive Services Task Force. Aspirin for the primary prevention of cardiovascular events: recommendation and rationale. Ann. Intern. Med. 2002; 136:157-60.
37 Lauer, M. Aspirin for the primary prevention of coronary events. N. Engl. J. Med. 2002; 346:1468-74.
38 Antiplatelet Trialists' Collaboration. Collaborative overview of randomised trials of antiplatelet therapy - I: prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. Br. Med. J. 1994; 308:81-106.
39 Hennekens, C. H., Dyken, M. L. and Fuster, V. Aspirin as a therapeutic agent in cardiovascular disease. A statement for health care professionals from the American Heart Association. Circulation 1997; 96:2751-3.
40 Smith, S. C., Blair, S. N., Bonow, R. O., et al. AHA/ACC Guidelines for preventing heart attack and death in patients with atherosclerotic cardiovascular disease: 2001 update. Circulation 2001; 104:1577-9.
41 Frishman, W. H. and Cheng, A. Secondary prevention of myocardial infarction: role of beta-adrenergic blockers and angiotensin-converting enzyme inhibitors. Am. Heart J. 1999; 137:S25-34.
42 Gheorghiade, M. and Golstein, S. Beta blockers in the post-myocardial infarction patient. Circulation 2002; 106: 394-8.
43 Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian simvastatin survival study (4S). Lancet 1994; 344:1383-9.
44 Lewis, S. J., Sacks, F. M., Mitchell, J. S., et al. Effect of pravastatin on cardiovascular events in women after myocardial infarction: the Cholesterol and Recurrent Events (CARE) Trial. J. Am. Coll. Cardiol. 1998; 32:140-46.
45 The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. Prevention of cardiovascular events and deaths with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N. Engl. J.Med. 1998; 339:1349-57.
46 Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high risk individuals: a randomized placebo-controlled trial. Lancet 2002; 360:7-22.
47 The Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin-converting enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N. Engl. J. Med. 2000; 342:145-53.
48 Yusuf, S. Two decades of progress in preventing vascular disease. Lancet 2002; 360:2-3.
49 American College of Cardiology and American Heart Association Task Force on Practice Guidelines. ACC/AHA guidelines for the management of patients with acute myocardial infarction. www.acc.org/clinical/guidelines/nov96/1999/ index.htm. Accessed September 23, 2002.
50 Mosca, L., Manson, J. E., Sutherland, S. E., et al. Cardiovascular disease in women. A statement for healthcare professionals from the American Heart Association. Circulation 1997; 96:2468-82.
51 DeLorgeril, M., Salen, P., Martin, J. L., et al. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report ofthe Lyon Diet Heart Study. Circulation 1999; 99:779-85.
52 American Heart Association. www.americanheart.org. Accessed September 23, 2002.
53 Boushey, C. J., Beresford, S. A. A., Omenn, G. S. and Motulsky, A. G. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease; probable benefits of increasing folic acid intakes. J. Am. Med. Assoc. 1995; 274:1049-57.
54 Nygard, O., Nordrehaug, J.E., Refsum, H., et al. Plasma homocysteine levels and mortality in patients with coronary artery disease. N. Engl. J. Med. 1997; 337:230-36.
55 Malinow, M. R., Bostom, A. G., Krauss, R. M. Homocysteine, diet and cardiovascular diseases: a statement for health care professionals from the nutrition committee, American Heart Association. Circulation 1999; 99:178-82.
56 Homocysteine Lowering Trialists' Collaboration. Lowering blood homocysteine with folic acid based supplements: meta-analysis of randomised trials. Br. Med. J. 1998; 316:894-8.
57 Schnyder, G., Roffi, M., Flammer, Y., Pin, R. and Hess, O. M. Effect ofhomocysteine-lowering therapy with folic acid, vitamin B 12, and vitamin B 6 on clinical outcomes after percutaneous coronary intervention: the Swiss Heart Study: a randomized controlled trial. J. Am. Med. Assoc. 2002; 288:973-9.
58 Grady, D., Herrington, D., Bittner, V., etal. Cardiovascular disease outcomes during 6.8 years of hormone replacement therapy: Heart and Estrogen/Progestin Replacement Study follow-up (HERS II). J. Am. Med. Assoc. 2002; 288:49-57.
59 Writing Group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results form the Women's Health Initiative randomized controlled trial. J. Am. Med. Assoc. 2002; 288:321-33.
Was this article helpful?