Results from a Multidisciplinary Integrative Approach for Cardiovascular Disease Prevention and Management Among Women: A Large Single Center Women`s Health Clinic Report

Background: Cardiovascular disease (CVD) is a leading cause of death among women. In recent years, awareness of sex specific risk factors and their impact on CVD have raised the need for women`s cardiac health centers (WCHC).

Aim: To summarize the activity of a unique WCHC, specializing in risk assessment and CVD management of women, through their hormonal life-cycle.

Methods: Between January 2014 to July 2017, 661 women were referred to the WCHC in Rabin Medical Center and underwent clinical evaluation and CVD risk assessment. Psychological intervention, imaging/invasive procedures, and endothelial function tests (EFT) were done according to the clinical work-up.

Results: The mean age was 55+ 14 years. Baseline characteristics, risk factors, and hormonal status are summarized in Table 1. Main referral reasons included personal initiative (30%), referral by treating physician (27%), and pregnancy-related complications (17%). Of interest, 14% of examined women had hypothyroidism, 55% were not physically active, and 18% had a psychological intervention. Overall, 72 women (11%) had a history of either cerebrovascular event or acute coronary syndrome, and 70 women (11%) had atherosclerosis established by imaging or angiography. In addition, 273 women underwent EFT. 43% of tests were abnormal (Reactive Hypermia Indexג‰₪ 1.74). Women with abnormal EFT were more likely to be smokers, diabetics, and had gestational complications, breast carcinoma and atherosclerosis.

Clinical Implications: Women- specific CVD risk factors, related to reproductive, hormonal and psychological status are often not sufficiently taken into medical consideration both in terms of primary and/or secondary prevention measures. Those factors impact CVD outcomes, and are important for life-time risk stratification and management. We highlight the importance of WCHC with distinctive integrative approach specifically geared towards women, in order to improve their CVD care and outcomes.