Cardiovascular Disease: The Number One Killer of Minority Women Statistics, Substrates, Solutions Nanette K. Wenger, M.D., MACP, FACC, FAHA Professor of Medicine (Cardiology) Emory University School of Medicine Chief of Cardiology Grady Memorial Hospital Consultant, Emory Heart & Vascular Center

Cardiovascular Disease: The Number One Killer of Minority Women The Statistics

Cardiovascular Disease: The Number One Killer of Minority Women  U.S. diversity 2050 ½ U.S. population racial, ethnic minorities U.S. women – racial, ethnic health disparities

Cardiovascular Disease: The Number One Killer of Minority Women Women of color Obstacles to health care linguistic, logistical barriers cultural differences sex, race-based stereotypes Differences in health status, health risk factors socioeconomic characteristics, access to care (women 70% Medicaid population > age 15) educational characteristics – awareness, screening disease incidence, mortality Making the Grade on Women’s Health: A National and State-by-State Report Card 2004, National Women’s Law Center,

Age-Adjusted Death Rates for Coronary Heart Disease, Stroke, and Lung and Breast Cancer for White and Black Females United States: 2001 Source:CDC/NCHS.

Leading Causes of Death for Hispanic or Latino Males and Females United States: 2001 A Diseases of the Heart, and Stroke B Cancer C Accidents DAssault (Homicide) EDiabetes Mellitus FInfluenza and Pneumonia Source:CDC/NCHS.

Leading Causes of Death for Asian/Pacific Islander Males and Females United States: 2001 A Diseases of the Heart, and Stroke B Cancer C Accidents DChronic Lower Respiratory Diseases EInfluenza and Pneumonia FDiabetes Mellitus Source:CDC/NCHS.

Leading Causes of Death for American Indian/Alaska Native Males and Females United States: 2001 A Diseases of the Heart, and Stroke B Cancer C Accidents DChronic Liver Disease and Cirrhosis EDiabetes Mellitus FChronic Lower Respiratory Diseases Source:CDC/NCHS.

National American Heart Association Survey Women’s Awareness 2003: Perceived Leading Cause of Death by Ethnic Group Mosca L et al. Circulation 2004; 109: % Breast CaCa (gen)Heart Disease Unsure White Black Hispanic

Cardiovascular Disease: The Number One Killer of Minority Women The Substrate (Burden of Coronary Risk Factors)

Age-Adjusted Prevalence Trends for High Blood Pressure in Americans Ages by Race/Ethnicity, Sex and Survey NHANES II & IV: and Source:CDC/NCHS. Health, United States, 2003.

Extent of Awareness, Treatment and Control of High Blood Pressure by Race/Ethnicity NHANES IV: Source:JAMA. 2003;290:

Prevalence of Current Smoking for Women Ages by Education and Race/Ethnicity NHANES III: Source:JAMA. 1999;281:

Prevalence of Moderate or Vigorous Physical Activity in Americans Age 20 and Older by Sex, Race/Ethnicity and BMI NHANES III: Note:BMI indicates body mass index: weight in kilograms divided by height in meters squared (kg/m 2 ). Source:CDC/NCHS.

Unhealthy Cholesterol Levels % Women 20 and older with cholesterol levels of 200 mg/dL or higher

High Blood Pressure % Women 20 and older

Physical Inactivity % inactive

Prevalence of Non-Insulin Dependent (Type 2) Diabetes in Women Ages by Education and Race/Ethnicity NHANES III: Source:JAMA. 1998;280:

Cardiovascular Disease: The Number One Killer of Minority Women The Solutions

Cardiovascular Disease: The Number One Killer of Minority Women  Awareness CVD racial/ethnic minority women  Awareness healthcare providers  Access screening, healthcare Aggressive implementation coronary risk reduction Target high-risk women Culturally appropriate