Heart Disease in Women - Hardcover

Wilansky MD, Susan; Willerson MD, James T.

Hardcover

ISBN 10: 0443079005 ISBN 13: 9780443079009

Publisher: Churchill Livingstone, 2001

Synopsis

Heart disease is one of the biggest killers of women, but a poorly researched area. This book provides a stand-alone guide for clinicians in the treatment of heart disease in their female patients. The text offers detailed coverage for treatment during pregnancy, and includes discussion of special topics such as AIDS, co-existing disease, and behavioral disorders.

About this title

About the Author:

Susan Wilansky, MD, Clinical Professor, Baylor College, Houston, TX; and James T. Willerson, MD, Professor and Chairman, Department of Internal Medicine, University of Texas Health Science Center, Houston, TX

From The New England Journal of Medicine:

Cardiovascular disease has been the leading cause of death among women for years, but a textbook on the unique characteristics of heart disease in women was virtually nonexistent just a decade ago. Fortunately, since Bernadine Healy, former director of the National Institutes of Health (NIH,) mandated that NIH-funded trials must include women, there has been much more information available on sex-specific diagnosis, management, and treatment of heart disease. Even so, since heart disease in women is still diagnosed later in the course of disease than it is in men, and since women are less likely to receive optimal therapies, it is important for physicians to have the latest information in this field. This textbook addresses the gap between our knowledge of cardiovascular disease in general and its presentation in women. The book contains a tremendous amount of information, covering coronary artery disease, of course, but also valvular disease, hypertension, arterial disease, and issues related to pregnancy. Especially helpful is the chapter entitled "Clinical Recognition: Risk Assessment Screening," which reviews methodologic considerations and cardiovascular epidemiology and presents useful tables that facilitate risk assessment in women. This chapter also explains in easily understood language the confounders in some studies of cardiovascular disease in women. Indeed, one of the challenges in culling data for a book on cardiovascular disease in women is that much of the literature does not provide sex-specific data. For this reason, some chapters contain substantially more sex-specific data than others. There is good coverage of sex differences in stress testing. However, the chapter on positron-emission tomography and ultrafast computed tomography for coronary calcification would benefit from a discussion of their use in women, although such data may be hard to find for these newer techniques. There are sex differences in acute coronary syndromes. Although clinical trials have shown the benefits of glycoprotein IIb/IIIa receptor inhibitors in men, the same studies suggest that these agents cause harm in women. Similarly, the Fragmin and Fast Revascularization during Instability in Coronary Artery Disease II trial and the third Randomised Intervention Treatment of Angina trial, which compared conservative treatment with early invasive treatment of acute coronary syndromes, showed a benefit in men but not in women. The rate of normal angiographic findings among women in clinical studies of acute coronary syndromes is much higher than that among men. This book would profit from further discussion and exploration of these sex differences. The book also suffers from the common problem of information that has become out of date by the time of publication. For example, in the chapter on the role of hormone therapy in coronary artery disease, the Postmenopausal Estrogen/Progestin Interventions Trial (1995) is called the "largest and latest trial" of hormone-replacement therapy. The most recent mortality data included in an overview of coronary artery disease are more than 10 years old. Nevertheless, the editors have assembled a comprehensive book and have included a discussion of psychosocial risk factors and behavioral barriers to health -- topics that often get short shrift. Our awareness and knowledge of sex differences in cardiovascular disease have advanced tremendously in the past decade. This book underscores the importance of routinely analyzing and reporting data from clinical trials according to sex, thereby permitting meta-analysis and reviews by groups such as the Cochrane Collaboration. When the next edition of this book is prepared, I hope we will have even more sex-specific information on cardiovascular disease. Rita F. Redberg, M.D.
Copyright © 2003 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

About this edition

• Publisher: Churchill Livingstone
• Publication date: 2001
• ISBN 10: 0443079005
• ISBN 13: 9780443079009
• Binding: Hardcover
• Edition number: 1
• Number of pages: 672