Promoting risk identification and reduction of cardiovascular disease in women through collaboration with obstetricians and gynecologists: A presidential advisory from the American Heart Association and the American college of obstetricians and gynecologists

In 2001, the Institute of Medicine (now known as the National Academy of Science) published a seminal monograph, Exploring the Biological Contributions to Human Health: Does Sex Matter?,1 describing the importance of both sex and gender on human biology and physiology. Gender-specific medicine, which recognizes gender differences and similarities in cardiovascular disease recognition, prevention, and management, has exerted a powerful salutatory effect on women. Significant improvement in mortality and morbidity rates in women have been seen over the past 2 decades, in part as a result of initiatives such as the American Heart Association's (AHA's) Go Red For Women movement. Go Red For Women initially focused on raising awareness of heart disease as the No. 1 killer of women. This campaign expanded gender-focused research and the development of gender-based guidelines that led to a significant reduction in the rates of death among women. Despite these advances, gender-based inequalities continue, with women being less likely to receive guideline-recommended diagnostic testing and therapies. Furthermore, despite the above-stated declines in mortality, more recently there has been an increase in mortality rates in women.2 Despite significant efforts to raise awareness about heart disease, the most recent data show that only 45% of women identify heart disease as their leading cause of death and that fewer than half of primary care physicians consider cardiovascular disease to be a top concern in women, after breast health and weight.3 A majority of women consider their obstetrician/gynecologist (OB/GYN) to be their primary care physician, particularly women during their childbearing years, and we know that many of the life-span milestones for women impart unique effects on cardiovascular health, particularly pregnancy and menopause. Shaw et al4 use the term healthcare team for women to describe the importance of collaboration among clinicians who care for women in order to improve quality and equitable healthcare gaps in women. We now know that 90% of women have at least 1 risk factor for developing heart disease and that optimal prevention strategies (eg, the AHA's Life's Simple 7) begin decades before clinical heart disease is apparent. For these and many other reasons, a partnership with an OB/GYN to optimize early identification and modification of risk factors for heart disease and stroke can be a critical element in improving women's health.