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10321 - Cardiovascular Disease in Black Women Rozann...

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Cardiovascular Disease in Black Women Rozann Hansford, R.N. MPH Candidate
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Cardiovascular Heart Disease Cardiovascular disease (CVD) refers to a wide variety of heart and blood vessel disorders including CHD, HTN, stroke, rheumatic heart disease Coronary Heart Disease (CHD) refers to several disorders that decrease blood supply to the heart muscle
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Pathophysiology of CHD Atherosclerosis is the underlying disease process Typically begins in childhood Slowly progressive,thickening of the inner layer of the arteries walls Incidence increases with age Not an inevitable consequence of aging
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Pathophysiology of CHD Disease progression starts with fat deposition and advances to fatty streaks with lipid core and calcium deposits As atherosclerosis progresses, arteries narrow enhancing possibility of endothelial disruption, hemorrhage and occlusive thrombosis (3)
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Pathophysiolgy of CHD Contributing factors include inflammatory, immunologic and hemostatic processes involving multiple systems and cellular types Persons most likely to suffer a myocardial infarction have <50% occlusion, not >70% occlusion as previously thought
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Biological differences between blacks and whites? It is not known whether cellular and molecular mechanisms of atherogenesis differ between races Blacks with hypertension respond less to angiotensin converting enzyme (ACE) inhibitors Blacks demonstrate greater fibrinolysis when receiving tissue plasmin activator (TPA) for myocardial infarction (4)
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Epidemiology of CHD in Black Women (US) Black Americans experience a higher morbidity/mortality compared with other racial/ethnic groups and have the highest age adjusted CHD mortality (1). CVD accounts for 41.6% of deaths in black women CHD death rates are 67% higher for black women compared to white women
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Epidemiology of CHD in Black Women CHD is particularly prevalent in black women younger than 55 years old who have 2.5 times the risk of CHD death compared to white women (6). Are black women deriving the same benefit from estrogen as white women? Black women have 2 times the rate of angina compared with white women and five times the rate of angina compare to black men.
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CHD Risk Factors in Black Women Framingham Heart Study….defined and quantified cardiac risk factors and related finding to cardiovascular outcomes Enrollment limited almost exclusively to whites Should this data be generalized to include all racial/ethnic mixes?
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