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Update in Women's Health

Carolyn Crandall, MD, MS; and Janet P. Pregler, MD
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From the Iris Cantor-UCLA Women's Health Center, David Geffen School of Medicine at the University of California at Los Angeles, Los Angeles, California.

Acknowledgments: The authors thank their colleagues at the David Geffen School of Medicine for their assistance in preparing this article.

Potential Financial Conflicts of Interests: None disclosed.

Requests for Single Reprints: Janet P. Pregler, MD, Iris Cantor-UCLA Women's Health Center, David Geffen School of Medicine at UCLA, 100 UCLA Medical Plaza, Suite 250, Los Angeles, CA 90077; e-mail, japregler@mednet.ucla.edu.

Current Author Addresses: Drs. Crandall and Pregler: Iris Cantor-UCLA Women's Health Center, David Geffen School of Medicine at UCLA, 100 UCLA Medical Plaza, Suite 250, Los Angeles, CA 90077.

Ann Intern Med. 2005;143(11):823-829. doi:10.7326/0003-4819-143-11-200512060-00011
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This Update in Women's Health reviews the past year's research publications that have the most relevance to the practice of internal medicine. We have included a summary of new guideline recommendations for the prevention of heart disease in women. Our selection process was guided by advice from our colleagues in general internal medicine, geriatrics, obstetrics and gynecology, cardiology, and oncology.

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Cardiovascular Disease Prevention for Women
Posted on February 17, 2006
Nancy Hsueh Beggs
UMDNJ-Robert Wood Johnson Medical School
Conflict of Interest: None Declared


In your recent issue, Crandler and Pregler, Update in Women's Health, recognize the American Heart Association Guidelines for Cardiovascular Disease Prevention in Women. Cardiovascular disease (CVD) has been identified as the number one killer of women in the United States and in most developed areas of the world. In the United States alone, more than one-half million women die of CVD each year, exceeding the number of deaths in men and the next 7 causes of death in women combined, disproportionately afflicting racial and ethnic minorities.

Recently the American Heart Association's published 5-point acronym for remembering the guidelines is "ALOHA." A"”Assess your risk and rank yourself as high, intermediate, or lower risk. L"”Lifestyle recommendations are priority No. 1 in heart disease prevention. O"”Other interventions are prioritized according to the expert panel rating scale. H"”Highest priority for therapy is for women at highest risk. A"”Avoid medical therapies called Class III.

I propose a new acronym as a pedagogical tool to better codify the guidelines in practitioners minds. I suggest "DRESS", tying the guidelines into the American Heart Association's national "Go Red-- Red Dress" campaign.

D-Discuss risk assessment: (Assess and stratify risk according to Framingham data and individual risk factors) R-Reinforce lifestyle interventions: (Smoking cessation, exercise, weight management, "heart-healthy" diet) E-Evaluate major risk factors: (Evaluate hypertension, hyperlipidemia, and diabetes and attain treatment goals according to recommended guidelines) S-Start helpful medications (Initiate evidence based pharmacology in high risk patients) S-Stop harmful medications (Avoid Class III harmful interventions such as menopausal hormone therapy, antioxidant, and aspirin in low risk patients)

I hope clinicians find this acronym helpful to implement these new guidelines to prevent cardiovascular death in women.

Nancy Hsueh Beggs, MD, FACP, Associate Professor of Medicine, UMDNJ/Robert Wood Johnson Medical School

Conflict of Interest:

None declared

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