II

104TH CONGRESS

2D SESSION S. 1910

To amend the Public Health Service Act to provide for expanding, intensifying, and coordinating activities of the National Heart, Lung, and Blood

Institute with respect to heart attack, stroke, and other cardiovascular

diseases in women.

IN THE SENATE OF THE UNITED STATES

JUNE 27, 1996

Mrs. BOXER introduced the following bill; which was read twice and referred

to the Committee on Labor and Human Resources

A BILL

To amend the Public Health Service Act to provide for

expanding, intensifying, and coordinating activities of the

National Heart, Lung, and Blood Institute with respect

to heart attack, stroke, and other cardiovascular diseases

in women.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Women’s Cardio5 vascular Diseases Research and Prevention Act’’.
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1 SEC. 2. FINDINGS.

2 The Congress finds as follows with respect to women

3 in the United States:

4 (1) Heart attack, stroke, and other cardio5 vascular diseases are the leading causes of death in

6 women.

7 (2) Heart attacks and strokes are leading

8 causes of disability in women.

9 (3) Cardiovascular diseases claim the lives of

10 more women each year than does cancer. Each year

11 more than 479,000 females die of cardiovascular dis12 eases, while approximately 246,000 females die of

13 cancer. Heart attack kills more than 5 times as

14 many females as breast cancer. Stroke kills twice as

15 many females as breast cancer.

16 (4) One in 5 females has some form of cardio17 vascular disease. Of females under age 65, each year

18 more than 20,000 die of heart attacks. In the case

19 of African-American women, from ages 35 to 74 the

20 death rate from heart attacks is approximately twice

21 that of white women and 3 times that of women of

22 other races.

23 (5) Each year since 1984, cardiovascular dis24 eases have claimed the lives of more females than

25 males. In 1992, of the number of individuals who
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1 died of such diseases, 52 percent were females and

2 48 percent were males.

3 (6) The clinical course of cardiovascular dis4 eases is different in women than in men, and cur5 rent diagnostic capabilities are less accurate in

6 women than in men. Once a woman develops a car7 diovascular disease, she is more likely than a man to

8 have continuing health problems, and she is more

9 likely to die.

10 (7) Of women who have had a heart attack, ap11 proximately 44 percent die within 1 year of the at12 tack. Of men who have had such an attack, 27 per13 cent die within 1 year. At older ages, women who

14 have had a heart attack are twice as likely as men

15 to die from the attack within a few weeks. Women

16 are more likely than men to have a stroke during the

17 first 6 years following a heart attack. More than 60

18 percent of women who suffer a stroke die within 8

19 years. Long-term survivorship of stroke is better in

20 women than in men. Of individuals who die from a

21 stroke, each year approximately 61 percent are fe22 males. In 1992, 87,124 females died from strokes.

23 Women have unrecognized heart attacks more fre24 quently than men. Of women who died suddenly
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1 from heart attack, 63 percent had no previous evi2 dence of disease.

3 (8) More than half of the annual health care

4 costs that are related to cardiovascular diseases are

5 attributable to the occurrence of the diseases in

6 women, each year costing this Nation hundreds of

7 billions of dollars in health care costs and lost pro8 ductivity.

9 SEC. 3. EXPANSION AND INTENSIFICATION OF ACTIVITIES

10 REGARDING HEART ATTACK, STROKE, AND

11 OTHER CARDIOVASCULAR DISEASES IN

12 WOMEN.

13 Subpart 2 of part C of title IV of the Public Health

14 Service Act (42 U.S.C. 285b et seq.) is amended by insert15 ing after section 424 the following section:

16 ‘‘HEART ATTACK, STROKE, AND OTHER CARDIOVASCULAR

17 DISEASES IN WOMEN

18 ‘‘SEC. 424A. (a) IN GENERAL.—The Director of the

19 Institute shall expand, intensify, and coordinate research

20 and related activities of the Institute with respect to heart

21 attack, stroke, and other cardiovascular diseases in

22 women.

23 ‘‘(b) COORDINATION WITH OTHER INSTITUTES.—

24 The Director of the Institute shall coordinate activities

25 under subsection (a) with similar activities conducted by

26 the other national research institutes and agencies of the
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1 National Institutes of Health to the extent that such Insti2 tutes and agencies have responsibilities that are related

3 to heart attack, stroke, and other cardiovascular diseases

4 in women.

5 ‘‘(c) CERTAIN PROGRAMS.—In carrying out sub6 section (a), the Director of the Institute shall conduct or

7 support research to expand the understanding of the

8 causes of, and to develop methods for preventing, cardio9 vascular diseases in women. Activities under such sub10 section shall include conducting and supporting the follow11 ing:

12 ‘‘(1) Research to determine the reasons under13 lying the prevalence of heart attack, stroke, and

14 other cardiovascular diseases in women, including

15 African-American women and other women who are

16 members of racial or ethnic minority groups.

17 ‘‘(2) Basic research concerning the etiology and

18 causes of cardiovascular diseases in women.

19 ‘‘(3) Epidemiological studies to address the fre20 quency and natural history of such diseases and the

21 differences among men and women, and among ra22 cial and ethnic groups, with respect to such diseases.

23 ‘‘(4) The development of safe, efficient, and

24 cost-effective diagnostic approaches to evaluating

25 women with suspected ischemic heart disease.
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1 ‘‘(5) Clinical research for the development and

2 evaluation of new treatments for women, including

3 rehabilitation.

4 ‘‘(6) Studies to gain a better understanding of

5 methods of preventing cardiovascular diseases in

6 women, including applications of effective methods

7 for the control of blood pressure, lipids, and obesity.

8 ‘‘(7) Information and education programs for

9 patients and health care providers on risk factors as10 sociated with heart attack, stroke, and other cardio11 vascular diseases in women, and on the importance

12 of the prevention or control of such risk factors and

13 timely referral with appropriate diagnosis and treat14 ment. Such programs shall include information and

15 education on health-related behaviors that can im16 prove such important risk factors as smoking, obe17 sity, high blood cholesterol, and lack of exercise.

18 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the

19 purpose of carrying out this section, there are authorized

20 to be appropriated $140,000,000 for fiscal year 1997, and

21 such sums as may be necessary for each of the fiscal years

22 1998 and 1999. The authorization of appropriations es23 tablished in the preceding sentence is in addition to any
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1 other authorization of appropriation that is available for

2 such purpose.’’.

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