The Women’s Health Initiative is a long-term national health study that started in April 1991. WHI is a result of a growing scientific interest and an urgent need for better understanding of the nature of women’s diseases. The entire project employed 161, 808 women of 50-79 years of age, and therefore, became one of the most far reaching women’s health experiments that have ever been taken in the U.S. The clinical trial consisted of three parts such as hormone therapy, dietary modification and calcium/vitamin D supplements. They were dedicated to the issue of preventing cancer, osteoporosis and heart disease. At the same time, a randomized clinical trial, an observational study and a community prevention study were those components that allowed to conduct medical research in detail and with accurate results.
In the Clinical Trial, it was demonstrated that such issues as hormones and diet had significant influence on the functioning of heart, so that disorders in such fields could have led to coronary heart disease. Moreover, clinical trial outcomes of hormone therapy and dietary modification were likely to lead exactly to this disease among others. The Observational Study employed those women who refused to take part in the Clinical Trial, and provided data for assessment of risk factors and the effect they had on heart. Such valuable information complemented the results gained in the Clinical Trial. The concluding component of the WHI study was aimed at developing such community-based prevention strategies that would stimulate women of different socioeconomic strata to apply healthful behaviors. Therefore, prevention of cardiovascular disease among the Black woman became a matter of priority on this level of study (“Women’s Health Initiative,” n.d.).
The main outcome of the study was the conclusion that hormone therapy is an important risk factor that influences the development of cardiovascular disease. Estrogen and Progestin may have potential harm to the body of a woman in her 50s and lead to consequences that are far from presumed benefit. The research conducted by Jean McSweeney, Christina M. Pettey, Elaine Souder, and Sarah Rhoads (2011) proves that “cardiovascular disease is the leading cause of death and disability in woman but it is primarily preventable” (p. 362). Therefore, it makes it extremely important to utilize all methods and approaches that possible in order to eliminate all possible risk factors and circumstances that lead to disease. They also emphasized that biology, sex and race may have an impact on or be contributors to the cardiovascular disease.
Women’s cardiovascular system should get due attention because, in general, the cardiovascular system has obvious sex-based differences, and only the reproductive system outperforms it. Therefore, these differences may affect risk factors by diminishing or multiplying their effect. The study also suggests that the main attention should be paid to hormones, as estrogen increases women’s risk of getting the disease, especially after menopause. At the same time, hormone therapy, namely estrogen therapy, suggested in the WHI study, does not significantly improve the risk profile of CVD. According to Jean McSweeney, Christina M. Pettey, Elaine Souder, and Sarah Rhoads (2011), “initiation of estrogen replacement therapy close to menopause for vasomotor effects does not adversely increase cardiovascular disease” (p. 363). At the same time, implementation of the estrogen hormone therapy after menopause has significant negative impact on the cardiovascular system, increasing the risk of getting the disease.
Genetic differences also add to the development of cardiovascular disease. Based on the Fiscella and Franks (2010) research, it turns out that African Americans have 38% higher mortality from heart diseases compared to White people. However, this is mostly the effect of poverty and poor living standards of African Americans. Moreover, “only 43% of black women and 44% of Hispanic women know that heart disease is their greatest health risk, compared to 60% of white woman” (“Cardiovascular Disease: Women’s No. 1 Health Threat,” 2013). Researches came to conclusion that the low Vitamin D level has a direct influence on the development of cardiovascular diseases. Therefore, checking Vitamin D level is highly recommended as heart diseases preventive measure.
Women’s health clinics have the unique opportunity to promptly assess CV risk because they mostly serve as primary health care providers for women. They collect such measurements as blood pressure and weight on the routine basis that allows basic monitoring of cardiovascular health. Except the hormone therapy, Jean McSweeney, Christina M. Pettey, Elaine Souder, and Sarah Rhoads (2011) suggest smoking cessation, healthy diet and physical exercises among the most necessary components of the CV prevention program. Ob-gyn clinics also can provide close screening for the women at high risk in order to prevent the disease or delay its development. Moreover, it should be taken into account that effect of certain medicines may vary between men and women, with it being more effective for men. For instance, “the drug digoxin used to treat patients with heart failure was associated with an increased risk of death among women, but not men” (“Cardiovascular Disease: Women’s No. 1 Health Threat,” 2013). Therefore, it is very important to count all these facts while developing a treatment program.
Consequently, the cardiovascular diseases represent the largest threat to the women’s health, especially after menopause. The WHI study demonstrated that lots of women in the U.S. are at high risk as they are exposed to risk factors or do not know much about diseases. Moreover, it is not sex differences, but also race has a significant impact on women’s predisposition to heart and blood vessel problems. Therefore, not only the hormone therapy, but also some general things like diet and non-smoking may help women in avoiding the disease.
References
Cardiovascular Disease: Women’s No. 1 Health Threat. (2013). American Health Association. Retrieved from http://www.heart.org/idc/groups/heart-public/@wcm/@adv/documents/downloadable/ucm_302256.pdf
Fiscelia, K., & Franks, P. (2010). Viatmin D, Race, and Cardiovascular Mortality: Findings from a National US Sample. Annals of Family Medicine, 8(1), 11-18. doi: 10.1370/afm/1035
McSweeney, J., Pettey, C.M., Sounder, E., and Rhoads, S. (2011). Disparities in Women’s Cardiovascular Health. JOGNN, 40, 362-371. Doi: 10/1111/j.1552-6909.2011.01239.x
Women’s Health Initiative. (n.d.). National Heart, Lung, and Blood Institute. Retrieved from http://www.nhlbi.nih.gov/whi/background.htm
