Women’s Heart Policy

1. Women’s Heart Policy October, 2004 Gastein John O’Toole (personal capacity) Perm Rep of Irl to EU

2. CVD largest killer of women in Europe • CVD number one killer in Europe, nearly half of all deaths for both sexes, 1 in 3 deaths globally • CVD is most common disease in EU • CVD is most common killer of women, 55% of all deaths in women are from CVD • More women die of CVD than of all cancers combined

3. CVD a neglected killer of women • CVD affects women 10 yrs later than men • Women less likely to survive MI than men • A woman has 50% of dying from first MI, compared with a 30% chance for a man • Of those who survive first MI, 38% of women will die within a year, compared to 25% of men • Twice as many women as men who have MI will be disabled • Stroke kills more women than men, although more men have strokes

4. Women and CVD • Reduced mortality but increased morbidity • Different risk factors: diabetes, stress, pill • Greatest risk factor for women is smoking • UK study found that women who drank > 21 units week 70% increased risk of stroke • Different treatment regimes, now smaller doses, catheters and stents

5. European Policy Initiatives • European Heart Network doing great work, set up informally in 1986, formally in 1992 • 1996 EHN debated issue of women & CVD at annual congress of ESC • Expert Report Euro Heart Health Initiative published February 1997 • 1998 Euro Heart Health Initiative by EHN • 2000 first World Heart Day

6. EU Policy Initiatives • Maastricht Treaty 1992 official EU role first time “major health scourges” • 1994 Council adopted a resolution on CVD • Commission report 1997 found: -gender differences diagnosis & treatment; outcomes & knowledge based on male • 2002 Council information point on CVD • 2003 Council healthy lifestyles • 2004 Year of Education though Sport

7. EU Public Health Programme 2001-2006 • Previously fragmented disease-oriented approach with thin spread of resources • Now strategic focus on key priorities which are integrated and mutually re-inforcing • Emphasis achieving & maintaining better health: information, action & promotion • Synergies with other Community policies • Exchange of best-practice

8. Irish EU Presidency 2004 • Heart Health chosen as the main theme • Partnership of Irish Presidency, European Commission, European Heart Network, European Society of Cardiology and WHO in association with US Department of Health & Human Services • Expert & Min meetings held in Lux & Cork • Council Conclusions agreed heart health

9. Irish Presidency 2004 • 1996 “Building Healthier Hearts” 211 recs • Common & consistent strategies to promote heart health • Share experiences, knowledge and approaches • Health promotion strategy take account of social, cultural, gender & age differences • Health determinants: diet, nutrition, excess alcohol, tobacco control & physical activity

10. Obstacles to EU Action • Public perception CVD as a “male” issue • Low awareness among women of CVD • Women fear cancer, esp. breast cancer • CVD risk is 10 times that of breast cancer • Absence of an EU legal health base • EU Public Health Funding

11. CVD is preventable • More gender-specific health policies • More gender-specific health information • More CVD research on women • Appropriate public health interventions NICO • Lifestyle changeswww.healthysteps.iewww.smokefreeatwork.ie • Promotion & treatment targeted at women • Multi-sectoral health promotion approach

12. A major Public Health Challenge • Need more ongoing surveillance • Need more timely intervention • Ageing of the Population • High prevalence of primary risk factors (obesity, smoking, sedentary) in women • Must involve women in design & delivery • Obesity a major cause CVD in future