Physician's Weekly Podcast

Why Are Women Dying Prematurely of CVD? And A Look At Pregnancy and Childbirth Safety

May 18, 2022 Physician's Weekly
Physician's Weekly Podcast
Why Are Women Dying Prematurely of CVD? And A Look At Pregnancy and Childbirth Safety
Show Notes

Welcome to this episode of Physician’s Weekly podcast. I am your host, Dr. Rachel Giles, from Medicom Medical Publishers in collaboration with Physician’s Weekly. And yes, this week I am grateful to have my voice at all, after 3 days of viral laryngitis. 

This week, women’s health has been all over the news, and that will be the topic of this week’s InDEPTH episode. May 8th through 14 was also the National Women’s Health Week, during which the U.S. Department of Health and Human Services’ Office on Women’s Health is encouraging women and girls to reflect on their individual health needs and take steps to improve their overall health.  The lenses of this InDEPTH dive are access to care and practice setting.

Women’s health remains a major problem in the US. In this episode we first take a look at maternal mortality in the US; the rate in the United States is roughly 20 maternal deaths per 100,000 births (about 700 deaths among the approximately 4 million people who give birth each year). Those statistics are not going down, but up for the last 15 years. American women today are 50% percent more likely to die because of pregnancy-related health issues than their mothers were. We interview Dr. Charles Jaynes, Vice President, Clinical Operations, Ob Hospitalist Group to understand the many factors that cause pregnancy and childbirth to remain unusually risky in the U.S. Based on recent CDC data, the leading causes of pregnancy-related deaths are cardiovascular conditions, infection, and hemorrhage.

With hypertension and heart disease being major contributors to maternal morbidity, our second interview takes a deeper dive into the factors that can facilitate timely detection of cardiovascular disease, particularly in women. Physician’s Weekly senior editor Martta Kelly interviews Dr. Carlos Iribarren, of the Kaiser Permanente Division of research in Oakland CA about his recent study, from the MINERVA  cohort study of over 5000 women.

They talk about how over the past decade, total and premature CVD deaths among women in the United States increased by 20,000 between 2009 and 2019. In addition to mortality, morbidity related to CVD has also increased, particularly among younger women. In the Atherosclerosis Risk in Communities Study between 1995 and 2014, the proportion of hospitalizations for acute myocardial infarction in young adults aged 35 to 54 years increased for women in contrast with a decline for men.  To curb the growing burden of CVD morbidity and mortality among women, innovative approaches to improve risk prediction and prevention of CVD are needed. Breast arterial calcification (BAC), a form of medial artery calcification that can be detected on routine mammography, has been proposed as a sex-specific marker for CVD risk among women. However, in contrast to coronary artery calcium, the biologic basis and clinical utility of BAC remains unclear given nearly two-thirds of United States women over the age of 40 undergo routine screening mammography every 1 to 2 years, the potential value of BAC for CVD risk estimation could impact millions of women without incurring extra cost or radiation exposure. The interview with Dr. Iribarren talks about their recently published data 

One note about Dr. Jaynes interview: he refers to ACOG a few times, which is an abbreviation for The American College of Obstetricians and Gynecologists, and also to the monthly journal published by that professional society as the “Green Journal”.

Enjoy listening!

More reading:

https://www.womenshealth.gov/nwhw/about

Iribarren C, Chandra M, Lee C, Sanchez G, Sam DL, Azamian FF, Cho HM, Ding H, Wong ND, Molloi S. Breast Arterial Calcification: a Novel Cardiovascular Risk Enhancer Among Postmenopausal Women. Circ Cardiovasc Imaging. 2022 Mar;15(3):e013526.