Identifying and supporting women's cardiovascular risk during the 3 hormonal phases: acting together!

In the space of 30 years, cardiovascular disease (CVD) has become the leading cause of death among women in France, killing 200 women a day. This medical and social emergency is due to changes in women's lifestyles and a lack of awareness of the specificities of cardiovascular risk for women, leading to frequent misdiagnoses.

A recent study by Axa Prévention Santé, published in September, highlights the fact that 81% of women neglect their own health in favour of that of their nearest and dearest; 70% believe that to be in good health is not to be ill, not to be 'prevented'; 77% regularly put off consultations and 85% try to treat themselves alone; and 42% of women never undergo screening for cardiovascular disease. And yet, at the same age, women present more risk factors than men. Certain risk factors, such as hypertension, smoking, diabetes and psycho-social stress, are also more deleterious in women, and are less well screened and controlled than in men. Women's cardiovascular risk is also governed by the rhythm of their hormonal life, and this very early on in adolescence, with the 1st contraception (with ethynil-estradiol), then pregnancies and later at menopause. Some women present emerging risk situations (migraine with aura, endometriosis, polycystic ovary syndrome, premature ovarian failure, inflammatory or autoimmune diseases...). Conversely, an optimized lifestyle is highly effective in preventive medicine for women. In 8 cases out of 10, the accident could even be avoided by maintaining key appointments with one's health. Predicting the risk of CV events in women remains a major challenge, as conventional risk scores do not take into account the specific characteristics of women. At the initiative of the Société Française d'HTA, a consensus of experts has just proposed a stratification of CVR adapted to French women (www.sfhta.eu), to guide healthcare professionals in the identification, screening and management of women at risk. Preventive vascular medicine is all about living long and in good health.
With this in mind, the "Agir pour le Cœur des Femmes/Women's CardioVascular Healthcare Foundation)" Endowment Fund was created in 2020, with 3 missions "Alert, Anticipate and Act" to save the lives of 10,000 women over 5 years.
It has just launched a national campaign to identify and support women in vulnerable situations, who are known to be particularly at risk of cardiovascular disease. Agir pour le Cœur des femmes and its Bus du Cœur des Femmes encourage women to listen to themselves and to go for screening.
At the same time, the implementation of the Bus stages federates a whole ecosystem of healthcare professionals, including vascular doctors, and social services players, encouraging the setting up of cardiovascular and gynecological health paths.
By 2022, 20 towns will be hosting the Women's Heart Bus, following a highly instructive initial assessment which highlighted the need to identify and support women in vulnerable situations who have left the usual care pathways.
Together, we can save lives and be true hummingbirds of prevention. It's our day-to-day responsibility to act rather than suffer.

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