MedicalResearch.com Interview with: Gregory YH Lip MD, FRCP (London, Edinburgh, Glasgow), DFM, FACC, FESC
Professor of Cardiovascular Medicine,
Adjunct Professor of Cardiovascular Sciences,
Thrombosis Research Unit, Aalborg University, Denmark;
Aston Centre for Cardiovascular Sciences City Hospital Birmingham
England UK
Medical Research: What is the background for this study? What are the main findings?
Prof. Lip: Women with atrial fibrillation are at higher risk of stroke than men with atrial fibrillation.
The reasons for this elevated risk remain unclear.
The results from our worldwide study suggest that women are treated no differently to men in terms of anticoagulant therapy for stroke prevention.
Thromboprophylaxis was, however, suboptimal in substantial proportions of men and women, with underuse in those at moderate-to-high risk of stroke and overuse in those at low risk.
(more…)
MedicalResearch.com Interview with:
Judith Lichtman, PhD, MPH
Associate Professor (with tenure)
Chair, Department of Chronic Disease Epidemiology
Yale School of Public Health
New Haven, CT 06520-803
Medical Research: What is the background for this study? What are the main findings?
Dr. Lichtman: Heart disease in younger women (18-55 years of age) is relatively rare, and represents less than 5% of all heart disease in women; however, young women who present with a heart attack are twice as likely to die in the hospital as compared with a similarly aged man, and this excess mortality risk continues beyond the index event. Delays in seeking prompt care has been suggested as one potential cause for the excess mortality in young women. We were interested in learning about the recognition of symptoms, perceived risk of heart disease, decision-making process to seek medical care, and interactions with the healthcare system among young women who recently had a heart attack. We found that even though the majority of young women presented with chest pain, they also experienced many other symptoms such as fatigue, nausea, muscle pain, and weakness. They commonly attributed symptoms to non-cardiac conditions because they felt they did not experience the “Hollywood Heart Attack” that is commonly portrayed in the media. Interestingly, despite reporting a strong family history of cardiac disease, and having multiple risk factors, many of the women we spoke with did not perceive they were at risk for heart disease, and many were not working with their physicians to manage their risk factors. They were also concerned about being seen as a hypochondriac if they reported their symptoms. Finally, women reported that the healthcare system was not consistently responsive when they reported their symptoms.
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MedicalResearch.com Interview with:
Jennifer L. Cook, MD FAHA
Assistant Professor of Medicine | Heart Failure and Transplantation
Medical Director Left Ventricular Assist Device Program
Medical University of South Carolina
Charleston, SC 29425
Medical Research: What is the background for this study? What are the main findings?
Dr. Cook: Although the incidence of heart failure is similar in men and women, women are more likely to die from it. Despite this fact a common misperception persists that men are at greater risk. Although advanced therapies such as mechanical support are as effective in women as in men, women are less likely to receive mechanical support. In clinical trials investigating mechanical support as a bridge to transplant less than 30% of patients were women. In trials investigating mechanical support for patients ineligible for heart transplant even fewer were women, less than 20%. .
Medical Research: What should clinicians and patients take away from your report?Dr. Cook: It has been shown that women with heart failure are more likely to remain under the care of a primary physician instead of being referred for specialized cardiovascular care. The explanation for this pattern is not understood. It is important to raise awareness and emphasize the high risk of heart failure mortality among women.
(more…)
MedicalResearch.com Interview with:
Claire Duvernoy, MD
Chief, Cardiology Section
VA Ann Arbor Healthcare System
Professor of Medicine
University of Michigan Health System Ann Arbor, MI
MedicalResearch: What is the background for this study? What are the main findings?Dr. Duvernoy: We wanted to look at the indications and outcomes for women veterans undergoing cardiac catheterization procedures as compared with men veterans, given that we know that there are significant gender differences in the non-veteran population between women and men undergoing cardiac catheterization.
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MedicalResearch.com Interview with:
Dr Miranda ArmstrongM.Phil.
Physical Activity Epidemiologist
Cancer Epidemiology Unit University of Oxford
Oxford, UK
Medical Research: What is the background for this study? What are the main findings?
Dr. Armstrong: Physical activity has generally been associated with reduced risk of heart disease. However, there is limited evidence on the associations between the frequency and durations of various activities with stroke and blood clots, especially in middle-aged women.
This is a very large study of 1.1 million middle-aged women, which confirms the benefits of moderate activity for reducing the risk of heart disease and stroke. Further to this, it shows that benefits may be more wide ranging than previously thought as the risk of blood clots was also lower in women reporting moderate activity when compared to inactive women. We found little evidence to suggest that activity more frequent than a few times per week provided further benefits in relation to these diseases.
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MedicalResearch.com Interview with:
Molly B. Conroy MD, MPHAssistant Professor of Medicine, Epidemiology, and Clinical and Translational ScienceUniversity of Pittsburgh, Pittsburgh, PA,
Medical Research: What is the background for this study? What are the main findings?
Response: The background for the study is the fact that middle-aged women are at high risk for being physically inactive, which puts them at higher risk for heart disease, cancer, and other chronic health problems.
We compared an interventionist-led physical activity and weight loss program delivered in coordination with primary care to a booklet that women were asked to use to exercise by themselves at home. We found that women who received the interventionist-led program had significantly greater increases in physical activity at 3 months, compared to women who received booklet. At 12 months, women who received the interventionist-led program were still more active than they were before starting the program, although the difference between the 2 groups was no longer significant.
(more…)
MedicalResearch.com Interview with:
Andrea Kaye Chomistek ScD
Assistant Professor Epidemiology and Biostatistics
Indiana University Bloomington
Medical Research: What is the background for this study? What are the main findings?
Dr. Chomistek: Although mortality rates from coronary heart disease in the U.S. have been in steady decline for the last four decades, women aged 35-44 have not experienced the same reduction. This disparity may be explained by unhealthy lifestyle choices. Thus, the purpose of our study was to determine what proportion of heart disease cases and cardiovascular risk factors (diabetes, hypertension, and high cholesterol) could be attributed to unhealthy habits.
We defined healthy habits as not smoking, a normal body mass index, physical activity of at least 2.5 hours per week, watching seven or fewer hours of television a week, consumption of a maximum of one alcoholic drink per day on average, and a diet in the top 40 percent of a measure of diet quality based on the Alternative Healthy Eating Index.
We found that women who adhered to all six healthy lifestyle practices had a 92 percent lower risk of heart attack and a 66 percent lower risk of developing a risk factor for heart disease. This lower risk would mean three quarters of heart attacks and nearly half of all risk factors in younger women may have been prevented if all of the women had adhered to all six healthy lifestyle factors. (more…)
MedicalResearch.com Interview with: Dr. Sunni Mumford PhD
Earl Stadtman Investigator in the DESPR Epidemiology Branch
Eunice Kennedy Shriver National Institute of Health and Human Development
Medical Research: What are the main findings of the study?Dr. Mumford:Depressive symptoms in healthy women who don’t have diagnosed clinical depression isn’t related to reproductive hormone levels, like estrogen, or impaired ovulation.
Medical Research: What was most surprising about the results?Dr. Mumford: Earlier research indicates that changes in estrogen may be associated with depression, for instance during the menopausal transition. Our study identified significant associations between estrogen and depressive symptoms in models that didn’t account for confounding factors, but this relationship was completed eliminated when adjustments were made for common confounding factors like age, race, BMI, and also stress level in these premenopausal women. Another interesting finding was that a score describing mood-related menstrual symptoms indicated that such symptoms are highest in the premenstrual phase, but remain lower throughout the rest of women’s cycles. This tells us that altered mood symptoms are most frequent prior to menstruation.
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MedicalResearch.com Interview with: Zainab Samad, M.D., M.H.S.
Assistant Professor of Medicine
Duke University Medical Center
Durham, North Carolina
Medical Research: What are the main findings of the study?Dr. Samad: This was a sub study of REMIT, an NHLBI funded study. Our research team headed by Dr. Wei Jiang conducted the REMIT study between 2006-2011 at the Duke Heart Center. We found that women and men differ significantly in their physiological and psychological responses to mental stress. We explored sex differences across various domains felt to have implications towards cardiovascular disease pathophysiology and prognosis. We found that women had greater negative emotion, less positive emotion, while men had greater blood pressure increases in response to mental stress. On the contrary, women showed greater platelet reactivity compared to men in response to mental stress. A greater frequency of women had cardiac ischemia in response to mental stress compared to men.
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MedicalResearch.com Interview with: Earl S. Ford, MD, MPH
Medical officer, U.S Public Health Service
Centers for Disease Control and Prevention
Atlanta, GA 30341
Medical Research: What are the main findings of the study?Dr. Ford: The main finding of the study is that mean waist circumference and the prevalence of abdominal obesity in US adults have increased since 1999-2000 and that these increases are being driven primarily by trends in women. Mean waist circumference and the percentage of abdominal obesity in men has been relatively stable since 2003-2004. (more…)
MedicalResearch.com Interview with: Sumeet S. Chugh MD
Pauline and Harold Price Endowed Professor
Associate Director, the Heart Institute
Section Chief, Clinical Cardiac Electrophysiology
Cedars-Sinai Medical Center, Los Angeles, CA
Medical Research: What are the main findings of the study?Dr. Chugh: Our study, conducted in the community, showed that there are unique alterations in sex hormone levels identified among patients who have sudden cardiac arrest. Male victims have lower testosterone and both males and females have higher estrogren levels.
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MedicalResearch.com Interview with: Melina Kibbe, MD, FACS, FAHA
Professor and Vice Chair of Research
Edward G. Elcock Professor of Surgical Research
Department of Surgery,Northwestern University
Institute for BioNanotechnology in Medicine Deputy Director
Medical Research: What are the main findings of the study?Dr. Kibbe: We found that approximately 1/3 of all peer-reviewed published manuscripts in 5 top surgery journals did not state the sex of the animal or cell used for research. Of those that did state the sex, 80% used only males.
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MedicalResearch.com Interview Invitation Dr. Eileen Hsich MD
Director of the Women’s Heart Failure Clinic
Associate Medical Director for the Heart Transplant Program
Cleveland Clinic, Cleveland, Ohio
Medical Research: What are the main findings of the study?Dr. Hsich:Women are dying on the heart transplant waiting list at a faster rate than men for almost a decade (see Figure 1) and few studies have even addressed this problem. The occurrence is largely driven by gender differences in survival at the most urgent status (UNOS Status 1A) but the cause remains unclear. Although data is limited our findings raise concern that women are not successfully bridged to transplantation while they remain at high status and are inactivated due to worsening condition.
Figure 1. Scientific Registry of Transplant Recipients: Mortality on Waiting List For Heart Transplantation
Figure derived from table in Scientific registry of transplant recipients: Heart waiting list by gender 2000-2009. Available at:
Http://srtr.Transplant.Hrsa.Gov/annual_reports/2010/1103_can-gender_hr.Htm
accessed january 9, 2014.(more…)
MedicalResearch.com Interview with: Jason D. Wright, M.D.
Levine Family Assistant Professor of Women's Health
Florence Irving Assistant Professor of Obstetrics and Gynecology
Division of Gynecologic Oncology
Columbia University College of Physicians and Surgeons
161 Fort Washington Ave, New York, New York 10032
Medical Research: What are the main findings of the study?Dr. Wright:This study is one of the first large scale studies to examine the risk of cancer specifically in women who underwent hysterectomy with electric power morcellation. Among 32,000 women treated at over 500 hospitals across the US we noted cancer in 27 per 10,000 women.
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MedicalResearch.com Interview with:
Aakriti Gupta, MD, MBBS
Center for Outcomes Research and Evaluation
Yale-New Haven Hospital,
New Haven, Connecticut
Medical Research: What were the main findings?
Dr. Gupta: Using a national database, we found that heart attack hospitalization rates for patients under the age of 55 have not declined in the past decade while their Medicare-age counterparts have seen a 20 percent drop.
We also found that among younger patients below 55 years of age, women fare worse because they have longer hospital stays, and are more likely to die in the hospital after a heart attack. Young women were also more likely to have higher prevalence of co-existing medical conditions including diabetes, high blood pressure and higher cholesterol levels. Overall, all patient groups in the study saw increases in these conditions including diabetes and high blood pressure in the past decade.
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MedicalResearch.com Interview with:Lisa A. McDonnell
Program Manager, Prevention & Wellness Centre,
Division of Prevention and Rehabilitation,
University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Medical Research: What are the main findings of the study?
Answer:The analysis focuses on a comparison of women’s perceptions of their heart disease knowledge and heart health risk with their self‐reported knowledge and heart health risk status. In summary, it gives insight into the Perceptions vs Reality when it comes to women and their heart health.
Heart disease knowledge:
For the purposes of measuring knowledge related to heart health, a scoring index was created on which women responding to the survey could score as low as 0 or as high as 40. The overall mean score among women in the survey was 15.0, which is fairly modest given the maximum of 40. In a comparison of actual and perceived heart disease knowledge, 80% of respondents with a low knowledge score perceived that they were moderately or well informed.
The risk factors that Canadian women most commonly associate with heart disease are being overweight/having abdominal obesity (ov/ob), physical inactivity, smoking, and lacking fruits/vegetables. Smoking, diabetes and high blood pressure account for up to 53% of MI’s, followed by Ov/Ob, psychosocial factors, a lack of physical activity, and a lack of fruits/vegetables. The limited awareness of high blood pressure, high cholesterol and diabetes as key risk factors is particularly surprising, given that these are key determinants of heart disease.
Low awareness of symptomology among women in our survey were noted when comparing the occurrence of symptoms versus their recognition of these symptoms as possibly being related to their heart. Only 4 in 10 women could name chest pain as a symptom of heart disease, and a smaller proportion could identify symptoms including dyspnea, radiating pain, or typical prodromal symptoms. Such shortcomings might contribute to the greater number of unrecognized myocardial infarctions in women than in men, not to mention inappropriate treatment of acute events and premature discharge from emergency care.
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MedicalResearch.com Interview with: David Strauss, M.D., Ph.D., Senior Author
Medical Officer
Center for Devices and Radiological Health
U.S. Food and Drug Administration, Silver Spring, Md
MedicalResearch: What are the main findings of the study?Dr. Strauss:The underrepresentation of women in clinical trials for cardiac resynchronization therapy (CRT) devices, as with other devices, has made it difficult to assess differences in the safety and effectiveness of these devices for women vs. men. The FDA is exploring the potential of pooling and analyzing data from multiple trials to bridge the knowledge gap for certain subpopulations (such as women) often underrepresented in medical device clinical trials. By conducting one such meta-analysis, the FDA found that women benefit from cardiac resynchronization therapy (CRT) significantly more than men do.
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MedicalResearch.com: Interview withRachel Thompson PhD
Postdoctoral Research Fellow
The Dartmouth Center for Health Care Delivery Science
Dartmouth College
MedicalResearch: What are the main findings of the study?Dr. Thompson: This study, which surveyed 417 women aged 15-45 years and 188 contraceptive care providers in 2013, found important differences in what matters most to these two groups when it comes to discussing and deciding on a contraceptive method. Women’s most important question when choosing a contraceptive was “Is it safe?” – this was in the top three questions for 42% of women but only 21% of providers. Alternatively, providers’ most important question was “How is it used?”. Information on side effects and how a method actually works to prevent pregnancy was also a higher priority for women than for providers.
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MedicalResearch.com Interview with: Luke Kim, M.D., FACC, FSCAI
Assistant Professor of Medicine
Interventional Cardiac and Endovascular Laboratory
Greenberg Division of Cardiology, Department of Medicine
Weill Cornell Medical College/The New York Presbyterian Hospital
MedicalResearch: What are the main findings of this study?Dr. Kim:The main findings of the study include:
From 2007-2011, there was no significant change in the rate of acute MI in both male and female cohorts in U.S. . Although there was a decline in the rate of ST-elevation (STEMI) in those ≥55 years old, the rate remains steady in patients < 55 years old, especially in the female cohort after 2009.
Female patients <55 years old with MI were sicker at baseline than the male counterparts with more likelihood of having diabetes, hypertension, chronic renal insufficiency, peripheral vascular disease, congestive heart failure and obesity.
Female patients were more likely to present with non– STEMI vs. STEMI and more likely to develop shock complicating their MIs.
Female patients are less likely to undergo coronary artery revascularization including percutaneous coronary intervention and coronary artery bypass surgery.
Unadjusted risk of death was higher in female vs male (5.2% vs. 3.7%, p<0.001) along with higher incidence of stroke (0.5% vs. 0.3%, p<0.001), bleeding (4.9% vs. 3.0%, p<0.001), vascular complication (0.6% vs. 0.4%, p<0.001) and ARF (11.6% vs. 9.6%, p<0.001). After adjustment, death (OR 1.10 CI 1.04-1.17), stroke (OR 1.31 CI 1.10-1.55), bleeding (OR 1.30 CI 1.22-1.37), and vascular complications (OR 1.33 CI 1.15-1.55) were all significantly higher for female cohort.
MedicalResearch.com Interview with:Roxanne Pelletier, PhD
Postdoctoral Fellow
Division of Clinical Epidemiology
McGill University Health Centre (MUHC)
687 Pine Avenue West, V Building, Room V2.17
Montreal, Qc
MedicalResearch.com: What made you want to study this disparity between men and women and heart attacks? Dr. Pelletier: Despite enhanced medical treatment and decrease in the incidence of heart diseases, important sex disparities persist in the risk of mortality following a cardiac event: the risk of mortality is higher in women compared to men, and this sex difference is even more important in younger adults. Therefore, we aimed to investigate potential mechanisms underlying this sex difference in mortality.
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MedicalResearch.com Interview with:Gang Hu, MD, MPH, PhD, FAHA
Assistant professor & Director
Chronic Disease Epidemiology Lab
Adjunct assistant professor, School of Public Health
LSU Health Sciences Center
Pennington Biomedical Research Center,
Baton Rouge, Louisiana
MedicalResearch.com: What are the main findings of the study?Dr. Gang Hu: Our study suggests a graded association between HbA1c and the risk of stroke among female patients with type 2 diabetes and poor control of blood sugar has a stronger effect in women older than 55 years.
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MedicalResearch.com Interview with:Michael Nyberg Ph.D.
Post-doc Human Physiology and Exercise Physiology
Integrated Physiology Group
Department of Nutrition, Exercise and Sports,
Faculty of Science, University of Copenhagen and
Jens Bangsbo, Dr. Sci., Ph.D.
Professor of Human Physiology and Exercise Physiology
Head of Integrated Physiology Group, Section of Human Physiology
Head of Copenhagen Centre of Team Sports and Health
Deputy Head of Department, research
Copenhagen Denmark
MedicalResearch.com: What are the main findings of the study?Answer: The main findings of the study were that despite being of similar age, the postmenopausal displayed higher blood pressure and higher blood levels of an early marker of atherosclerosis than women that had not reached menopause. Furthermore, just 12 weeks of floorball training twice a week for one hour improved the women’s conditions and reduced their blood pressure significantly. In addition, there was positive development in levels of substances vital to blood vessel function, including a decrease in the early marker of atherosclerosis.
(more…)
MedicalResearch.com Interview with:
JoAnn E. Manson, MD, DrPH
Chief, Division of Preventive Medicine
Brigham and Women's Hospital
Professor of Medicine and the
Michael and Lee...
MedicalResearch.com Interview with Dr. Pietro Manuel Ferraro
Division of Nephrology–Renal Program, Department of Internal Medicine and Medical Specialties, Columbus-Gemelli Hospital, Rome, Italy
MedicalResearch.com: What are the main findings of the study?Dr. Ferraro: We analyzed three large cohorts over time to see if those with prevalent or incident kidney stones might have a higher risk of developing coronary heart disease (fatal or non fatal myocardial infarction or the need for coronary revascularization). The cohorts consisted of over 200,000 participants without any prior history of coronary heart disease. After a median follow-up of over 8 years, we observed that women affected with stones seem to have a greater risk of developing coronary heart disease independent of a number of other known cardiovascular risk factors such as diabetes or high blood pressure. We did not observe a significant association among men. (more…)
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