With mortality rates from ischemic heart disease (IHD) continuing to rise in young women between the ages of 36 and 54 years, a new JACC Review Topic of the Week developed by the ACC’s Cardiovascular Disease in Women Committee offers “pragmatic, evidence-based management strategies” for clinicians.

As part of the paper, Margo B. Minissian, PhD, ACNP, CLS, AACC, et al., reviewed the latest published evidence and identified knowledge gaps as they apply to younger women in the areas of acute coronary syndromes, spontaneous coronary artery dissection, implications of IHD in pregnancy, coronary artery spasm, myocardial infarction with no obstructive coronary arteries, and coronary microvascular dysfunction.

They also highlight some of the largest challenges in managing this specific patient group, including “significant socioeconomic disparities in IHD risk factors and outcomes” due to reduced access to care, lower-income levels, language and cultural barriers, and limited guidance from current research.

Minissian and colleagues stress the need for future research and implementation science, as well as policies to “provide affordable health insurance and consistent access to care and primary prevention across a woman’s lifespan.” They also provide the following six actionable strategies to guide future focus:

1. Utilize technology to engage and educate young women on optimal lifestyle strategies and the impact of these strategies on cardiovascular health
2. Use cutting-edge digital approaches to tailor effective cardiovascular management to reduce IHD
3. Educate health care providers to implement established evidence-based guidelines in young women for primary and secondary prevention of IHD as well as bias training
4. Standardize processes of care to overcome biases
5. Report clinical and institutional data by sex and race/ethnicity to assess adherence to evidence-based guidelines and appropriateness of care
6. Increase participation of young women in clinical research to create guidelines driven by sex-specific data, including research on IHD pathophysiology in women

Read the full article.

Clinical Topics: Acute Coronary Syndromes, Prevention

Keywords: Coronary Vessels, Acute Coronary Syndrome, Cardiovascular Diseases, Ethnic Groups, Implementation Science, Longevity, Secondary Prevention, Myocardial Ischemia, Risk Factors, Socioeconomic Factors, Myocardial Infarction, Health Personnel, Primary Prevention, Insurance, Health, Health Services Accessibility, Technology, Policy

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