Identification of women's coronary heart disease and risk factors prior to first myocardial infarction.
OBJECTIVE
To understand when women's coronary heart disease (CHD) and CHD risk factors are recognized prior to first myocardial infarction (MI).


METHODS
Medical record review of the 10 years prior to incident MI among women with a confirmed incident MI between January 1, 1996, and December 31, 2001, to determine the timing of CHD diagnosis as well as assessment and treatment for risk factors.


RESULTS
One hundred fifty women had incident MIs during the study period. They made 8732 ambulatory visits and had 457 hospitalizations during the period of review (mean 9.1 years, range 6.2-10 years). Average age at incident MI was 74.7 years (SD 12.6, range 38.9-99.8 years). A CHD diagnosis prior to first MI was present in 52% (n = 78) of the women but was less common in those <70 years (p = 0.001). All but 3 women had one or more modifiable risk factors identified prior to their first MI. Treatment of recognized risk factors varied from 81% (antihypertension medications) to only 28% (drug therapy for abnormal lipid levels). Having a diagnosis of CHD was associated with an increased likelihood of having identified risk factors and receiving drug treatment for identified risk factors.


CONCLUSIONS
Women with undiagnosed CHD (48%) and those with unrecognized or untreated risk factors for CHD, especially younger women, represent missed opportunities for prevention of cardiac events.
Yawn
Barbara P
BP
Department of Research, Olmsted Medical Center, Rochester, Minnesota 55904, USA. yawnx002@umn.edu
Wollan
Peter C
PC
Jacobsen
Steven J
SJ
Fryer
George E
GE
Roger
Veronique L
VL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003327:Coronary Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D048909:Diabetes Complications / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D006304:Health Status; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications; D006973:Hypertension / Q000150:complications; D008499:Medical Records; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D016387:Women's Health