Monday December 17, 2018

Still lot to know about women’s heart says Indian origin cardiologist

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Washington: For the first time there was a release of a scientific statement on female heart attacks by The American Heart Association(AHA). The statement highlighted existing knowledge gaps and outlined the priority steps needed to better understand and treat heart disease in women.

The statement chaired by Dr Laxmi Mehta, a cardiologist at the Ohio State University’s Wexner Medical Centre, compiles the newest data on symptoms, treatments and the types of heart attacks among women.

“Over the last 10 years or so, we’ve learned that women’s hearts are different than men’s in some significant ways and while that’s helped reduce mortality, there’s much more to know,” said Mehta, who is also director of Ohio State’s women’s cardiovascular health programme.

Cardiovascular disease is the leading cause of death for women globally.

While men and women both experience chest pain as a primary heart attack symptom, women often have atypical, vague symptoms without the usual chest pain such as palpitations, pain in the back, shoulder or jaw, even anxiety, sweating or indigestion.

Some women may only experience shortness of breath, nausea, vomiting or flu-like symptoms.

“These symptoms can be very challenging for the patient and the medical profession. Women tend to under recognise or deny them. When they do present to the emergency department, it is important for these symptoms to be triaged appropriately as potential heart problems,” Mehta emphasised.

Delay in seeking treatment is more common among women than men. The authors report several factors can lead to a delay in seeking help for heart attack symptoms.

“Living alone, interpreting symptoms as temporary or not urgent, consulting with a doctor or family member first and fear of embarrassment if the symptoms aren’t serious are some of them,” the authors noted.

“We don’t yet clearly understand why women have different causes and symptoms of heart attacks,” Mehta said.

“Women are more complex, there are more biological variables such as hormonal fluctuations. That’s why more research is needed,” she said.

Social, environmental and community differences also play a role in how women’s treatment outcomes differ from men’s.

More women have depression related to heart disease, which can hinder their treatment.

Women less often complete cardiac rehabilitation due to the competing work and family responsibilities and lack of support.

Frankly, women are great at nagging their spouses, so they make sure their partner takes their medications, goes to cardiac rehab, eats better and sees the doctor.

“Unfortunately. many women don’t make their own personal health their priority, which contributes to more favourable outcomes in men versus women after a heart attack,” Mehta noted.

Certain cardiovascular risk factors are more potent in women, including Type 2 diabetes and high blood pressure.

There is also growing evidence that emotional stress and depression can influence the onset and course of heart disease in women.

“The first step to help improve outcomes for women is attention to gender-specific characteristics and disparities to improve awareness, prevention, recognition and treatment in women with heart disease,” Mehta said.(IANS)

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Trump Can’t Deny Birth Control Coverage: U.S. Court

The case became more complicated after the Trump administration last month issued new birth control coverage rules that are set to supersede those at issue in the lawsuit before the 9th Circuit.

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birth control, contraceptive
A one-month dosage of hormonal birth control pills is displayed in Sacramento, Calif. VOA

A divided U.S. appeals court Thursday blocked rules by the Trump administration that allowed more employers to opt out of providing women with no-cost birth control.

The ruling, however, may be short lived because the administration has adopted new rules on contraceptive coverage that are set to take effect next month and will likely prompt renewed legal challenges.

Thursday’s ruling by a three-judge panel of the 9th U.S. Circuit Court of Appeals concerned changes to birth control coverage requirements under President Barack Obama’s health care law that the U.S. Department of Health and Human Services issued in October 2017.

States were likely to succeed on their claim that those changes were made without required notice and public comment, the appeals court panel said in a 2-1 decision.

USA, birth control
A man stands outside the main door of the 9th U.S. Circuit Court of Appeals building in San Francisco. VOA

The majority upheld a preliminary injunction against the rules issued by U.S. District Judge Haywood Gilliam last year. It, however, limited the scope of the injunction, applying it only to the five states in the lawsuit and not the entire country.

Another federal judge also blocked the rules, and her nationwide injunction remains in place.

An email to the Justice Department seeking comment was not immediately returned.

Obama’s health care law required most companies to cover birth control at no additional cost, though it included exemptions for religious organizations. The new policy allowed more categories of employers, including publicly traded companies, to opt out of providing free contraception to women by claiming religious objections. It also allowed any company that is not publicly traded to deny coverage on moral grounds.

The Department of Justice said in court documents that the rules were about protecting a small group of “sincere religious and moral objectors” from having to violate their beliefs. The changes were favored by social conservatives who are staunch supporters of President Donald Trump.

Reproductive Rights, abortion, women, birth control
A community health worker holds up contraceptives during a lecture on family planning at a reproductive health clinic run by an NGO in Tondo city, metro Manila. VOA

California filed a lawsuit to block the changes that was joined by Delaware, Maryland, New York and Virginia.

“Today’s decision is an important step to protect a woman’s right to access cost-free birth control and make independent decisions about her own reproductive health care,” California Attorney General Xavier Becerra said in a statement.

‘Economic harm’

The states argued that the changes could result in millions of women losing free birth control services, forcing them to seek contraceptive care through state-run programs or programs that the states had to reimburse.

The states show with “reasonable probability” that the new rules will lead women to lose employer-sponsored contraceptive coverage, “which will then result in economic harm to the states,” 9th Circuit Judge J. Clifford Wallace, a nominee of Republican President Richard Nixon, wrote for the majority.

Reproductive Rights, abortion, women, birth control
Newer Contraception Tries to Engage Men. VOA

In a dissent, 9th Circuit Judge Andrew Kleinfeld said the economic harm to the states was “self-inflicted” because they chose to provide contraceptive coverage to women. The states, therefore, did not have the authority to bring the lawsuit, said Kleinfeld, a nominee of Republican President George H.W. Bush.

Also Read: To Diversify The Industry, Apple Pledges To Train More Women

The case became more complicated after the Trump administration last month issued new birth control coverage rules that are set to supersede those at issue in the lawsuit before the 9th Circuit. Under the new rules, large companies whose stock is sold to investors won’t be able to opt out of providing contraceptive coverage.

Wallace said the new rules did not make the case before the 9th Circuit moot because they are not set to take effect until January. (VOA)