National Observatory on Women's Health 2023 - Part 1

Agir pour le Coeur des Femmes publishes the first part of its Observatoire national de la
Santé des Femmes. Analysis of medical data from a panel of 4,300 women aged between 14 and 95
years (average age 54) screened in the Bus du Coeur des Femmes in 2021 and 2022 provides
a unique panorama of women's cardiovascular and gynecological health in France.
With 90% of participants having at least 2 cardiovascular risk factors, the risk is real
risk is real and insufficiently managed. In addition, the influence of
influence on cardiovascular risk is not as great as might be imagined.
ALL women are concerned.

1. All women are concerned.
For the first time, we have used the Epices score from the Assurance Maladie, which measures
measure the degree of economic and social precariousness based on objective criteria. 56% of
women screened were in a precarious situation defined by a simplified Epices
score = 4.
The main finding is that cardiovascular risk is not as strongly correlated with the level of
as one might imagine. Most women in socio-professional categories
do not undergo a cardiovascular check-up. If
obesity and smoking rates are higher among women in vulnerable situations
situation, there is little or no difference in arterial hypertension, sedentariness, stress
sedentary lifestyle, stress, depression and medical follow-up according to level of precariousness...
2. Cardiovascular risk remains highly under-treated
90% of participants accumulate at least 2 cardiovascular risk factors. 50%
cumulate at least 2 gyneco-obstetrical risk factors. Among the 3,878 women with
at least two cardiovascular risk factors, 51% also had at least two gyneco-obstetrical
obstetrical risk factors. 79% had no cardiovascular follow-up and 37% no gynaecological follow-up.
gynaecological follow-up. The risk is real. Only 10% of the population screened is at very low risk
cardiovascular and gyneco-obstetrical risk. When a woman has two risk factors
risk factors, she almost always has at least two cardiovascular risk factors.
cardiovascular risk factors.
3. Hypertension remains largely under-diagnosed and under-treated.
under-treated.
39% of women have high blood pressure figures at screening, above 140/90,
a third of whom had very high figures (>160). Among women who declared themselves to be
hypertension at the initial interview, 32% are taking treatment for their hypertension. Worse still
almost 2 out of 3 women on treatment (62%) maintain high blood pressure levels
hypertension, with blood pressure above 140/90 at screening.
4. Many women take estrogen-progestin contraception, which is contraindicated
for cardiovascular or metabolic reasons.
Thus, among the 173 women in the panel taking contraception with synthetic estrogens
61% (106) have a contraindication: aged over 35 or BMI over
over 30, active smoking or other conditions (migraine with aura, uncontrolled diabetes, etc.). It is not
not acceptable to die because of contraindicated contraception.
5. Menopause requires reinforced gynecological and cardiovascular follow-up.
Among the 66% of women in the menopausal panel (n = 2,830), the median age at menopause is
50 years. 26% of these menopausal women are taking a hormonal menopause
which reinforces the importance of regular gynecological and cardiovascular check-ups. This
which is not the case, see below.
6. Insufficient medical follow-up
12% of women have no general practitioner, 79% have no cardiovascular follow-up, 37%
have no gynaecological follow-up (no gynaecological examination for over a year).
7. Cardiovascular risk factors are present.
62% of women are overweight, with a BMI over 25
30% of women are obese, with a body mass index > =30
23% claim to be sedentary, but in reality 40% are insufficiently physically active
15% are smokers.
21% drink too much alcohol
12% regularly take potentially addictive medications.
8. High exposure to psychosocial stress.
68% of women report stress
27% have a depressive syndrome
9. A particularly encouraging satisfaction rate
97% of the women were very satisfied with their time on the Bus, and have become aware
of the importance of their health. They will talk about the importance of screening to those around them,
They'll be talking about the importance of screening to those around them, becoming prevention relays for their loved ones.
One of the key findings of this panel study is that the onset of menopause
menopause is not yet under control in France in terms of cardiovascular, metabolic
cardiovascular, metabolic and gynecological risks. All women, whatever their
whatever their socio-professional category, need a long, free consultation
cardiovascular and gynecological consultation at the onset of menopause, like that carried out for
contraception and first pregnancy.
We need to reverse these figures, while cardiovascular disease still kills 200 women a day
a day, 76,000 women a year, and are still the leading cause of death in women (CEPIC
Inserm 2015; beh.santepubliquefrance.fr/beh/2019/29-30). It is urgent to continue these
and educational initiatives on a large scale in a spirit of benevolence.
benevolence. 

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