Gynecologists urged to screen for heart disease

Screening women for heart disease at obstetrics and gynecology clinics may detect cardiovascular risk and head off heart problems for women who do not see a primary care physician, researchers said.

Many women do not have a primary care physician but seek out basic OB/GYN services, the researchers said.

Women often are undertreated or unaware of risk factors for heart disease, yet it is the leading cause of death among women in the United States. And the rate of heart-related death in women between the ages of 35 and 44 continues to increase 1 percent per year, the researchers said.

"Women take care of their breasts and get mammograms and take care of their bones by getting bone density tests, but often neglect their hearts," said Dr. Roxana Mehran, director of interventional cardiovascular research and clinical trials at Mount Sinai Medical Center in New York City, and the lead researcher in a two-year pilot program that studied the issue.

"Many women are unaware of the risk factors," she said in an interview.

The results from the pilot program were presented at the scientific sessions of the American College of Cardiology in Chicago this week.

The program was implemented in OB/GYN clinics at 10 U.S. medical centers to screen 2,234 women, with a mean age of 53, for cardiovascular risk or disease in OB/GYN clinics.

Patients completed a short survey about heart disease risk factors, including family history, and details on symptoms they may have been experiencing.

Researchers found cardiovascular risk factors were present in more than two-thirds of the women screened.

Symptoms, from mild fatigue to severe chest pain, were seen in four of every ten patients.

These results, she said, suggest that a simple cardiovascular assessment in OB/GYN clinics can increase prevention of heart disease and provide critical education to women. The cost of doing this is low and the survey can be completed in two or three minutes, Mehran said.

"It's a great opportunity," she added.

Among the women screened, researchers found that close to two of every 10 considered their OB/GYN doctor as their primary healthcare provider.

"We think that number would have been higher - maybe 25 to 30 percent - if we had included more inner-city clinics," Mehran said.

About two in 10 patients did not know or had never had testing of their blood pressure or blood sugar levels, and almost four in ten did not know their cholesterol levels or had never had cholesterol tests.

After screening, a quarter of the women were referred either to a primary care physician, a cardiologist or endocrinologist for further evaluation and treatment.

Nearly half of the women in the program were postmenopausal. Among those patients, almost a third were on hormone replacement therapy.

Mehran said the next step is to broaden the sample of patients to include women of lower socioeconomic groups.

The study was funded by Abbott Laboratories Inc.