Women missing out on treatment for cardiovascular disease
Women are still missing out on vital treatment for cardiovascular disease, despite progress in the medical management of heart disease and stroke, a consensus statement published online in the journal Heart has said.
Women across the world continue to be underdiagnosed, undertreated and underrepresented in clinical trials in all areas of cardiovascular disease, says the statement. Among other things, it calls for dedicated women's heart champions and heart hubs, plus a women's health strategy, to stop the needless death toll from what is essentially, preventable disease.
The consensus statement was drawn up by representatives from UK cardiovascular, nursing, and patient bodies affiliated with the British Cardiovascular Society, with the aim of addressing unmet needs, ensuring parity of care, and improving the health outcomes of women with cardiovascular disease in the UK, and worldwide.
Conventional cardiovascular disease risk factors, such as high blood pressure and high cholesterol, are often not treated as promptly or as appropriately as they are in men, despite accounting for around half of all preventable cardiovascular disease deaths, says the statement. Women face particular cultural, societal, and financial issues, which magnify their heart disease risks, as well as enduring the influence of hormones, pregnancy, and the menopause, across their lifespan.
Their biology, physiology, and body shape not only affect their risks of cardiovascular disease, but also the effectiveness of diagnostic procedures and treatment, it adds.
Health professionals and the public mistakenly believe that women's risk of cardiovascular disease is lower than men's, says the statement: ‘Myths and unconscious biases within clinical practices and societal perceptions further obscure the reality that heart disease does not discriminate by sex’. Health professionals, professional bodies, charities, and the NHS can do their bit through co-ordinated campaigns with unified messaging to raise the profile of women's heart health, the authors conclude.
Professor André Ng, President of the British Cardiovascular Society, said: ‘The joint British Cardiovascular Societies’ consensus document is the first to comprehensively detail the many layers of inequalities that exist in relation to cardiovascular disease in women, who clearly need better access to early and accurate diagnosis and timely treatment. Raising awareness across the medical profession, to patients and the general public is an important first step.
‘The British Cardiovascular Society will work with our affiliated societies in all areas of cardiology as well as other stakeholders, including patient organisations and NHS leaders, to identify key work packages that will bring transformative change to improve care and achieve better outcomes for cardiovascular care in female patients.’
The study in full can be found at: https://heart.bmj.com/content/early/2024/09/17/heartjnl-2024-324625.
Fruquintinib approved to treat adult patients with metastatic colorectal cancer
The Medicines and Healthcare products Regulatory Agency (MHRA) has approved fruquintinib (Fruzaqla) to treat adult patients with metastatic colorectal cancer.
The application for approval was supported by evidence obtained from two studies (FRESCO-2 and FRESCO). FRESCO-2 involved 691 adults with previously treated metastatic colorectal cancer. The studies included patients who had disease progression on, or who were intolerant to, chemotherapy, biologics, and trifluridine/tipiracil (TAS-102) and/or regorafenib.
FRESCO was conducted in China and involved 416 adults with previously treated metastatic colorectal cancer who had disease progression during or after prior fluoropyrimidine, oxaliplatin, and irinotecan-based chemotherapy.
People treated with Fruzaqla lived for an average of 9.3 months compared with 6.6 months for those who received placebo.
In FRESCO-2, people treated with Fruzaqla lived for an average of 7.4 months compared with 4.8 months for those who received placebo.
The study showed that people treated with Fruzaqla lived for an average of 3.7 months without their disease getting worse, compared with an average of 1.8 months for people who received placebo. The approval of fruquintinib is for a recommended dose of 5 mg once daily for 3 weeks, followed by 7 days (1 week) of rest (no medicine). This is 1 cycle of treatment.
The MHRA says it will keep the safety and effectiveness of fruquintinib under close review.
Anyone who suspects they are having a side effect from this medicine are encouraged to talk to their doctor, pharmacist or nurse and report it directly to the Yellow Card scheme.
The new marketing authorisation was granted to Takeda UK Limited. The product was submitted and approved via a national procedure, as part of an Access Consortium New Active Substance Work-Sharing Initiative.
Air pollution, high temperatures and metabolic risk factors are ‘driving global increases in stroke’
There was a rapid rise in the global stroke burden between 1990 and 2021 due to population growth and the rise of aging populations worldwide, as well as an increase in exposure to environmental and behavioural risk factors.
The findings of this new analysis from the Global Burden of Disease, Injuries, and Risk Factors Study were published in The Lancet Neurology.
More than three-quarters of those affected by stroke live in low- and middle-income countries. It is suggested that worldwide, the overall amount of disability, illness, and early death (DALYs) lost to stroke increased by 32% between 1990 and 2021, rising from around 121.4 million years of healthy life lost in 1990 to 160.5 million years in 2021, making stroke the fourth leading cause of health loss worldwide after COVID-19, ischaemic heart disease, and neonatal disorders.
Between 1990 and 2021, the global stroke burden linked to high body mass index (BMI; up by 88%), high temperatures (up 72%), high blood sugar (up 32%), diets high in sugar-sweetened drinks (up 23%), low physical activity (up 11%), high systolic blood pressure (up 7%), and diets low in omega-6 polyunsaturated fatty acids (up 5%) increased substantially.
However, if the impact of demographics is removed through age-standardisation (to allow comparisons between countries and over time), there has been a trend towards lower rates (age-standardised per 100 000 population) of incidence (down by 22%), prevalence (down 8%), deaths (down 39%), and DALYs (down 39%) worldwide, and across virtually all country income levels, since 1990. Since 2015, improvements in global incidence rates have stagnated, while age-standardised rates of stroke incidence, death, prevalence and DALYs have got worse in south-east Asia, East Asia, Oceania and in people younger than 70 years.
The current study builds on previous analyses to provide the most up-to-date and comprehensive analysis of stroke burden and risk factor estimates in countries on a global scale between 1990 and 2021, to help guide health-planning, prevention and resource allocation.