Risk Factors and Secondary Prevention in Women with Heart Disease
Authors: Saif S. Rathore, Harlan M. Krumholz
Journal: Annals of Internal Medicine (2003)

Letters2 December 2003Risk Factors and Secondary Prevention in Women with Heart DiseaseSaif S. Rathore, MPH and Harlan M. Krumholz, MDSaif S. Rathore, MPHFrom Yale University School of Medicine, New Haven, CT 06520-8025.Search for more papers by this author and Harlan M. Krumholz, MDFrom Yale University School of Medicine, New Haven, CT 06520-8025.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-11-200312020-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We were disappointed by Vittinghoff and colleagues' evaluation of secondary prevention in the Heart and Estrogen/progestin Replacement Study (HERS) (1). We believe concerns of undertreatment of women are important but were not supported by the data presented and were misinterpreted in the accompanying editorial (2) and press reports (3).Treatment rates were presented with the assumption that all patients should be treated and that shortfalls represented poor-quality care. This assumption is incorrect because the authors did not account for treatment ineligibility or contraindications that may have justified nonuse of some therapies. Without this information, it is not ...References1. Vittinghoff E, Shlipak MG, Varosy PD, Furberg CD, Ireland CC, Khan SS, . Risk factors and secondary prevention in women with heart disease: the Heart and Estrogen/progestin Replacement Study. Ann Intern Med. 2003;138:81-9. [PMID: 12529088] LinkGoogle Scholar2. Miller AP, Oparil S. Secondary prevention of coronary heart disease in women: a call to action [Editorial]. Ann Intern Med. 2003;138:150-1. [PMID: 12529098] LinkGoogle Scholar3. Sexual divide in heart treatment. CBSNews.com. Accessed at www.cbsnews.com/stories/2003/01/21/health/main537357.shtml on 27 October 2003. Google Scholar4. Marciniak TA, Ellerbeck EF, Radford MJ, Kresowik TF, Gold JA, Krumholz HM, . Improving the quality of care for Medicare patients with acute myocardial infarction: results from the Cooperative Cardiovascular Project. JAMA. 1998;279:1351-7. [PMID: 9582042] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Yale University School of Medicine, New Haven, CT 06520-8025. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRisk Factors and Secondary Prevention in Women with Heart Disease: The Heart and Estrogen/progestin Replacement Study Eric Vittinghoff , Michael G. Shlipak , Paul D. Varosy , Curt D. Furberg , Christine C. Ireland , Steven S. Khan , Roger Blumenthal , Elizabeth Barrett-Connor , Stephen Hulley , and Secondary Prevention of Coronary Heart Disease in Women: A Call to Action Andrew P. Miller and Suzanne Oparil Risk Factors and Secondary Prevention in Women with Heart Disease Michael G. Shlipak , Eric Vittinghoff , and Stephen Hulley Metrics 2 December 2003Volume 139, Issue 11Page: 954KeywordsACE inhibitorsAngiotensin converting enzymeAspirinCardiovascular therapyEstrogen replacement therapyHealth care qualityLongitudinal studiesMedical risk factorsMedicareMyocardial infarction ePublished: 2 December 2003 Issue Published: 2 December 2003 CopyrightCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...