Computer generated transcript

Warning!
The following transcript was generated automatically from the content and has not been checked or corrected manually.

Women and CVD When it’s atheroma 28 June 2022 7.30pm BST @Lwnurses #LWN #LearnWithNurses Michaela Nuttall RGN MSc Becky Warnes Founder, Learn With Nurses Independent Business Consultant, Becky Warnes Consultancy Ltd Director, Smart Health Solutions GHP, Private Healthcare Awards:Business Consultant of the Year 2022 Associate in Nursing, C3 Collaboratingfor Health The SiliconReview: Top 20 Companies to watch in 2022 Chair, Health CareCommittee HEART UK @warnes_becky Member, Nurses WorkingParty and Guidelines & Information WorkingParty, British and IrishHypertension Society Trustee, PoTS UK @thisismichaela Using Medall To get slides To get certificateMedall.org getting certificates/slidesClosed FB group & Page Women and CVD • Part 1 - When it’s atheroma • Part 2 - When it’s probably not atheroma • Part 3 - Hormones • And of course, the quizWe weren’t designed to live this long….284 peeps.. So far What percentage of people involved in research about CVD are women? 38.2% 41.1% 42.7% 45.8% 49.9% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% What percentage of people involved in research about CVD are women? 38.2% 41.1% 42.7% 45.8% 49.9% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%What percentage of female deaths each year are due to CVD? 21% 51% 35% 45% 41% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%What percentage of female deaths each year are due to CVD? 21% 51% 35% 45% 41% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% How many women in the UK have a heart attack each day? 22 59 98 101 122 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% How many women in the UK have a heart attack each day? 22 59 98 101 122 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% The average delay between the onset of symptoms and arrival at hospital for men ranges between 1 hour 24 minutes and 3 hours 30 - what is it for women? 1 hour 31 minutes and 5 hours 30 minutes 1 hour 48 minutes and 7 hours 12 minutes 3 hour 48 minutes and 4 hours 12 minutes 7 hour 48 minutes and 12 hours 12 minutes 1 hour 31 minutes and 12 hours 12 minutes 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% The average delay between the onset of symptoms and arrival at hospital for men ranges between 1 hour 24 minutes and 3 hours 30 - what is it for women? 1 hour 31 minutes and 5 hours 30 minutes 1 hour 48 minutes and 7 hours 12 minutes 3 hour 48 minutes and 4 hours 12 minutes 7 hour 48 minutes and 12 hours 12 minutes 1 hour 31 minutes and 12 hours 12 minutes 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%Why the delay? • CVD kills more women than all the cancers combined and yet only 44% recognise it as their biggest threatWhy the delay? • CVD kills more women than all the cancers combined and yet only 44% recognise it as their biggest threat What percentage of women get an initial diagnosis which is wrong when having a heart attack? 20% 30% 40% 50% 60% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% What percentage of women get an initial diagnosis which is wrong when having a heart attack? 20% 30% 40% 50% 60% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Why? • Not enough known • Clinicians' perspective • Angiograms not as effective in diagnosis heart disease in women • It might not be ‘traditional’ atheroma (next session) They told me I was just having a panic attack, so I was taken • Lack of inclusion in research to the hospital with no urgency. • Inequalities Levels of troponin in women who have experienced heart attacks are? Similar to those in men Higher than those in men Lower than those in men 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Levels of troponin in women who have experienced heart attacks are? Similar to those in men Higher than those in men Lower than those in men 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% How much higher is a woman's risk of developing heart failure or dying within 5 years of their first heart attack (when compared to men)? 20% 9% 12% 50% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% How much higher is a woman's risk of developing heart failure or dying within 5 years of their first heart attack (when compared to men)? 20% 9% 12% 50% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Early menarche, early first birth and early menopause are all separately associated with increased risk of CVD in later life? True False – the risk is the same False - the risk is lower 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Early menarche, early first birth and early menopause are all separately associated with increased risk of CVD in later life? True False – the risk is the same False - the risk is lower 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%Early menarche, early first birth and early menopause Other Steroid Cortisol Transgender women were found to have increase in the rate of myocardial infarction compared to cisgender women, even after adjusting for other risk factors such as age, smoking and other diseases. How much is this increase? This is not true 2-fold 3-fold 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Transgender women were found to have increase in the rate of myocardial infarction compared to cisgender women, even after adjusting for other risk factors such as age, smoking and other diseases. How much is this increase? This is not true 2-fold 3-fold 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Hormone Replacement Therapy used to treat menopause symptoms is shown to give some protection against CHD when started early? True False 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Hormone Replacement Therapy used to treat menopause symptoms is shown to give some protection against CHD when started early? True False 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% HRT and CVD Risk Cardiovascular effects of estrogen Indirect Direct non-genomic Direct Genomic • Increases HDL • Increases cardiovascular • Increases endothelial cell • Decreases LDL production of Nitric and platelet NO Oxide (NO) in production • Reduction in LDL endothelial cells, smooth • Inhibits calcium currents oxidation muscle cells and and activation of myocardial cells potassium channels • Inhibits VSMC & • Reduces vascular Myocardial growth and constriction remodelling Summary • The inequalities are vast • It is acknowledged there is a lack of research in women • There is a movement for change, it’s going to take a while