The National Institute of Health has promoted the National Project on Gender Medicine with the aim of assessing which are the most frequent pathologies in woman and how to implement a prevention program. We carry
article Mirella Taranto Institute of Health
"The Project" Gender as Medicine for Public Health Strategic Objective: The Appropriateness of Care for the Protection of Women's Health " was established with the funds of the Targeted Research of the Ministry of Labour, Health and Welfare of 2.7 million euro. Integra biomedical knowledge on metabolic diseases (diabetes, atherosclerosis, etc.), on occupational medicine, on reazioni avverse ai farmaci, che sono più frequenti e gravi nella donna, con quelle sociali ed economiche per arrivare a programmi di prevenzione e a linee guida genere-mirate. Partecipano al progetto tre Regioni, di cui due come capofila (Sardegna, Sicilia) e una unità della Regione Toscana, l’ISPESL-Roma, un’unità dell’Agenzia Servizi Sanitari Regionali, Roma; 2 IRCCS (Istituto Dermatologico San Gallicano-I.F.O. IRCCS-Roma, IRCCS San Raffaele Pisana-Roma), un Consorzio Interuniversitario -INBB, 8 Università degli Studi (Cagliari, Firenze, Messina, Modena, Piemonte Orientale-Novara, Roma- La Sapienza, Roma Tor Vergata, Sassari).
Nello specifico, i settori di studio sono:
• Malattie metaboliche e salute della donna: studi patogenetici e approcci terapeutici innovativi (ISS- responsabile S. Vella)
• Ormoni sessuali come determinanti "di genere" nella risposta immune e nello sviluppo di malattie autoimmuni e metaboliche (istituto Dermatologico San Gallicano-I.F.O.- IRCCS-responsabile M. Picardo)
• Interferenti endocrini negli ambienti di lavoro e salute della donna (Ispesl-responsabile A. Pera)
• Malattie iatrogene e reazioni avverse ai farmaci (Regione Sicilia- responsible A. De Sarro)
• determinants of health of women, preventive medicine and quality of care (Sardinia-responsible Franconi F.)
Some data
Women live longer, but ill more and use more health services (the so-called "paradox of woman"). For example, according to ISTAT figures of 2007, 6% suffer from disabilities that affect their daily functioning (vision, hearing, movement) to 3% of men. of osteoporosis 9% of women suffer from just 1% of men with depression 7.4% against their male counterparts del 3%. Sono sottopeso sono il 5.8% delle donne contro lo 0.9% degli uomini.
In tema di fruizione dei servizi sanitari, sempre l’ISTAT attesta che il 18% delle donne contro il 14% degli uomini si sottopone a visite generiche; il 16% a visite specialistiche contro il 12.4% degli uomini e che ben il 50.7% delle donne consuma farmaci contro una percentuale maschile del 39.5%.
Il diabete mellito , malattia cronica che affligge il 5-6% della popolazione, colpisce nel nostro Paese soprattutto le donne anziane (oltre i 75 anni) del Mezzogiorno ( 5,2%), seguite da quelle del Centro (4,5%) e del Nord ( 3,9%). Questa malattia elimina purtroppo la protezione conferita alle donne rispetto the risk of cardiovascular disease and the effects of diabetes than men with diabetes die of cardiovascular disease (2.2 to 1.7 times for men). In recent years, moreover, there was a reduction of mortality in men but not in females. There are
autoimmune diseases that predominantly affect the female sex: in Italy, for example, 250,000 women suffering from rheumatoid arthritis in the bronchial asthma , in the age group 2-5 years, is more common in males (2:1 compared to females) to have an abrupt change in the trend after 20 years. This clearly shows that there are differences between the immune system of male and female. "
The following tables summarize the key differences that are found in both sexes about the diseases and treatments.
TABLE 1: Some Women Men Morbidity
Disability (confined to bed) 10.9% 5.6% Other
disability (daily functions, movement,
vision, hearing, speech) 6.1% 3.3%
multicronicità rates 17.2% 10.3%
Osteoarthritis / arthritis 21.8% 14.6% 9.2%
Osteoporosis 1,1%
Cefalea 10.5% 11,8%
Ipertensione arteriosa 15,4% 11,8%
Diabete 4,7% 4,3%
Depression and anxiety 7.4% 3.1%
-Alzheimer senile dementia 0.6% 0.3%
TABLE 2: Risk factors
Women Uomini
Soprappeso 26,6% 42,5%
Sottopeso 5,8% 0,9%
Fumo 16,3% 27.5%
TABLE 3: USE OF HEALTH SERVICES
Women Men
visits generated 18.2% 13.8%
Specialist visits 12.4% 16.1%
Views a pagamento 59,0% 54,9%
Accertamenti diagnostici 12,8% 10,8%
Consumo di farmaci 50,7% 39,5%
Ricoveri ospedalieri Non differente Not unlike
rehabilitation services 4.1% 3.1%
vaccination 18.8% 21.5%
We also carry excerpts of an article of Maria Grazia Modena and Annachiara Nuzzo (Institute of Cardiology, University of Modena and Reggio Emilia, Azienda Policlinico, Modena), which shows an increase of cardiovascular disease in women and underestimation of the risk in women.
"is missing to date attention on the impact that gender differences have on the pathophysiology and, therefore, the treatment of the most common social diseases, including cardiovascular diseases
. For these reasons The worrying aspect is that, in our opinion, lead to meditation not only class but also the cardiac General Practitioner (GP) is
the growing number of reports in the literature concerning the general underestimation of ischemic heart disease (CI ) in women . Indeed, against this disease, attention is constantly carried out in a advanced stage, or treatment is less aggressive than that given to the patient man. According to recent estimates, CI kills more than 500,000 American women during one year, 41.3% of total deaths of women, a larger percentage than the deaths from cancer (Fig. 1). In Italy (Fig. 2), women who die each year due to cardiovascular disease is approximately 120,000.
Despite this evidence, it still tends to consider such a specific condition of the male sex. For many years, the study of coronary artery disease and its risk factors has affected mostly men, given the greater frequency of the disease in middle age, the
appearance at a younger age than in women and high lethality. Until the menopause
the frequency of the disease and levels of risk factors are lower than men, with age differences are reduced and the values \u200b\u200bare similar or become higher than those found in men. The substantial underestimation of the problem suggested the paradoxical observation that "perhaps the most important risk factor for ischemic heart disease in women is the misperception that heart disease is a disease of women."
"pathological studies show that, in humans, plaques on artery walls begin to appear around the age of 30 years, will increase proportionally to the level of serum cholesterol, blood pressure, obesity and the number of cigarettes smoked, and
reach the "critical" in a period can range from 40 to 70 years (natural history of CI in humans). In women, however, the fertile period (rich in estrogen) has extended the date of onset of the plates, then induced by the same risk factors, but the criticality is reached at the age of
65-80 years (15-20 years later than men). "
" However, there are some subtle differences regarding hypertension, diabetes, physical activity, HDL cholesterol (high density lipoprotein) and triglycerides, the perception of illness and psychosocial conditions. There are, of course, differ as to secure the event
menopause and its unique and peculiar antidote, estrogen replacement therapy. "
" As part of a proper primary prevention (desirable goal by GPs) is extremely important to recommend to women, especially postmenopausal, seriato control of blood pressure and, in case of detection of high blood pressure, repeated checks, change of lifestyle and pharmacological intervention targeted, although there are no uniform guidelines on this because there are many studies that have involved women. The
smoke is the leading cause of preventable death for women: more than 50% of myocardial infarctions were associated with tobacco use in the series by Kawachi et al. and the magnitude of excess risk, from 2 to 4 times higher, is similar in men and women, with a clear dose-response relationship, because even "small" smokers (1 to 4 cigarettes a day) have
a higher risk of developing coronary heart disease double compared with women who do not smoke.
Another important factor, which actually looks like a library or cluster of the most important risk factors, metabolic syndrome is . Main protagonist of this syndrome is insulin resistance, a condition characterized by the presence, in the same subject, some metabolic disorders, and in several epidemiological studies is associated with an increase of approximately three times the risk of developing cardiovascular events and about six times to develop diabetes. "
TABLE I
Posts lifestyle.
Cigarette smoking: all women should avoid cigarette smoke through rehabilitative programs or pharmacological smoking cessation defect (class I , level B).
•
Physical activity every woman should run a minimum of 30 minutes of moderate physical activity (brisk walking) per day (class I, level B). For women who need to reduce their body weight, moderate physical activity should be of 60-90 minutes per day (class I, level C).
• Rehabilitation after a recent hospitalization for coronary syndrome or cardiac surgery, a cerebrovascular event (class I, level A) or heart failure with ejection fraction (EF) < 40% (class I, level B), tutte le donne
need a period in a rehabilitation program.
• Diet: All women should eat a diet rich in fruits, vegetables, fiber and fish at least twice a week. The intake of saturated fats should be < 10% (se possibile < 7%), il colesterolo < 300 mg/die, il consumo di sale < 2,3 g/die, l’alcol limitato a non più di un drink al giorno (class I, level B).
• Body weight: every woman should maintain an appropriate body weight through the proper intake of calories, moderate physical activity in order to achieve a body mass index (BMI) between 18.5 and 24.9 (class I, level B). •
omega-3 fatty acids: added to the diet at doses of 850-1000 mg per day may be considered in women with heart disease the maximum dose of 2-4 g / day, for the treatment of hypertriglyceridemia (Class IIb, level B).
• Depression: assessing the presence of this disease in all women diagnosed with heart disease, and initiate a specific treatment (class IIA, level B). •
(Moscow et al. Mod..)
The article will focus primarily on the fact that cardiovascular risk also exists in women. Maybe in the past it was considered that women were somewhat more protected from these diseases. Differences exist, however, that the speech should be addressed to prevent the same way as for men.
The important message is that cardiovascular disease can be prevented in both women and men. So
awareness of cardiovascular risk and other diseases, as seen in Mirella Taranto, in women, as humans, can automatically be associated with important preventive measures. All to try to avoid in future, the growing trend of increased mortality from cardiovascular causes and incidence of other diseases among women worldwide.
Nello specifico, i settori di studio sono:
• Malattie metaboliche e salute della donna: studi patogenetici e approcci terapeutici innovativi (ISS- responsabile S. Vella)
• Ormoni sessuali come determinanti "di genere" nella risposta immune e nello sviluppo di malattie autoimmuni e metaboliche (istituto Dermatologico San Gallicano-I.F.O.- IRCCS-responsabile M. Picardo)
• Interferenti endocrini negli ambienti di lavoro e salute della donna (Ispesl-responsabile A. Pera)
• Malattie iatrogene e reazioni avverse ai farmaci (Regione Sicilia- responsible A. De Sarro)
• determinants of health of women, preventive medicine and quality of care (Sardinia-responsible Franconi F.)
Some data
Women live longer, but ill more and use more health services (the so-called "paradox of woman"). For example, according to ISTAT figures of 2007, 6% suffer from disabilities that affect their daily functioning (vision, hearing, movement) to 3% of men. of osteoporosis 9% of women suffer from just 1% of men with depression 7.4% against their male counterparts del 3%. Sono sottopeso sono il 5.8% delle donne contro lo 0.9% degli uomini.
In tema di fruizione dei servizi sanitari, sempre l’ISTAT attesta che il 18% delle donne contro il 14% degli uomini si sottopone a visite generiche; il 16% a visite specialistiche contro il 12.4% degli uomini e che ben il 50.7% delle donne consuma farmaci contro una percentuale maschile del 39.5%.
Il diabete mellito , malattia cronica che affligge il 5-6% della popolazione, colpisce nel nostro Paese soprattutto le donne anziane (oltre i 75 anni) del Mezzogiorno ( 5,2%), seguite da quelle del Centro (4,5%) e del Nord ( 3,9%). Questa malattia elimina purtroppo la protezione conferita alle donne rispetto the risk of cardiovascular disease and the effects of diabetes than men with diabetes die of cardiovascular disease (2.2 to 1.7 times for men). In recent years, moreover, there was a reduction of mortality in men but not in females. There are
autoimmune diseases that predominantly affect the female sex: in Italy, for example, 250,000 women suffering from rheumatoid arthritis in the bronchial asthma , in the age group 2-5 years, is more common in males (2:1 compared to females) to have an abrupt change in the trend after 20 years. This clearly shows that there are differences between the immune system of male and female. "
The following tables summarize the key differences that are found in both sexes about the diseases and treatments.
TABLE 1: Some Women Men Morbidity
Disability (confined to bed) 10.9% 5.6% Other
disability (daily functions, movement,
vision, hearing, speech) 6.1% 3.3%
multicronicità rates 17.2% 10.3%
Osteoarthritis / arthritis 21.8% 14.6% 9.2%
Osteoporosis 1,1%
Cefalea 10.5% 11,8%
Ipertensione arteriosa 15,4% 11,8%
Diabete 4,7% 4,3%
Depression and anxiety 7.4% 3.1%
-Alzheimer senile dementia 0.6% 0.3%
TABLE 2: Risk factors
Women Uomini
Soprappeso 26,6% 42,5%
Sottopeso 5,8% 0,9%
Fumo 16,3% 27.5%
TABLE 3: USE OF HEALTH SERVICES
Women Men
visits generated 18.2% 13.8%
Specialist visits 12.4% 16.1%
Views a pagamento 59,0% 54,9%
Accertamenti diagnostici 12,8% 10,8%
Consumo di farmaci 50,7% 39,5%
Ricoveri ospedalieri Non differente Not unlike
rehabilitation services 4.1% 3.1%
vaccination 18.8% 21.5%
We also carry excerpts of an article of Maria Grazia Modena and Annachiara Nuzzo (Institute of Cardiology, University of Modena and Reggio Emilia, Azienda Policlinico, Modena), which shows an increase of cardiovascular disease in women and underestimation of the risk in women.
. For these reasons The worrying aspect is that, in our opinion, lead to meditation not only class but also the cardiac General Practitioner (GP) is
the growing number of reports in the literature concerning the general underestimation of ischemic heart disease (CI ) in women . Indeed, against this disease, attention is constantly carried out in a advanced stage, or treatment is less aggressive than that given to the patient man. According to recent estimates, CI kills more than 500,000 American women during one year, 41.3% of total deaths of women, a larger percentage than the deaths from cancer (Fig. 1). In Italy (Fig. 2), women who die each year due to cardiovascular disease is approximately 120,000.
Despite this evidence, it still tends to consider such a specific condition of the male sex. For many years, the study of coronary artery disease and its risk factors has affected mostly men, given the greater frequency of the disease in middle age, the
appearance at a younger age than in women and high lethality. Until the menopause
"pathological studies show that, in humans, plaques on artery walls begin to appear around the age of 30 years, will increase proportionally to the level of serum cholesterol, blood pressure, obesity and the number of cigarettes smoked, and
reach the "critical" in a period can range from 40 to 70 years (natural history of CI in humans). In women, however, the fertile period (rich in estrogen) has extended the date of onset of the plates, then induced by the same risk factors, but the criticality is reached at the age of
65-80 years (15-20 years later than men). "
" However, there are some subtle differences regarding hypertension, diabetes, physical activity, HDL cholesterol (high density lipoprotein) and triglycerides, the perception of illness and psychosocial conditions. There are, of course, differ as to secure the event
menopause and its unique and peculiar antidote, estrogen replacement therapy. "
" As part of a proper primary prevention (desirable goal by GPs) is extremely important to recommend to women, especially postmenopausal, seriato control of blood pressure and, in case of detection of high blood pressure, repeated checks, change of lifestyle and pharmacological intervention targeted, although there are no uniform guidelines on this because there are many studies that have involved women. The
smoke is the leading cause of preventable death for women: more than 50% of myocardial infarctions were associated with tobacco use in the series by Kawachi et al. and the magnitude of excess risk, from 2 to 4 times higher, is similar in men and women, with a clear dose-response relationship, because even "small" smokers (1 to 4 cigarettes a day) have
a higher risk of developing coronary heart disease double compared with women who do not smoke.
Another important factor, which actually looks like a library or cluster of the most important risk factors, metabolic syndrome is . Main protagonist of this syndrome is insulin resistance, a condition characterized by the presence, in the same subject, some metabolic disorders, and in several epidemiological studies is associated with an increase of approximately three times the risk of developing cardiovascular events and about six times to develop diabetes. "
TABLE I
Posts lifestyle.
Cigarette smoking: all women should avoid cigarette smoke through rehabilitative programs or pharmacological smoking cessation defect (class I , level B).
•
Physical activity every woman should run a minimum of 30 minutes of moderate physical activity (brisk walking) per day (class I, level B). For women who need to reduce their body weight, moderate physical activity should be of 60-90 minutes per day (class I, level C).
• Rehabilitation after a recent hospitalization for coronary syndrome or cardiac surgery, a cerebrovascular event (class I, level A) or heart failure with ejection fraction (EF) < 40% (class I, level B), tutte le donne
need a period in a rehabilitation program.
• Diet: All women should eat a diet rich in fruits, vegetables, fiber and fish at least twice a week. The intake of saturated fats should be < 10% (se possibile < 7%), il colesterolo < 300 mg/die, il consumo di sale < 2,3 g/die, l’alcol limitato a non più di un drink al giorno (class I, level B).
• Body weight: every woman should maintain an appropriate body weight through the proper intake of calories, moderate physical activity in order to achieve a body mass index (BMI) between 18.5 and 24.9 (class I, level B). •
omega-3 fatty acids: added to the diet at doses of 850-1000 mg per day may be considered in women with heart disease the maximum dose of 2-4 g / day, for the treatment of hypertriglyceridemia (Class IIb, level B).
• Depression: assessing the presence of this disease in all women diagnosed with heart disease, and initiate a specific treatment (class IIA, level B). •
(Moscow et al. Mod..)
The article will focus primarily on the fact that cardiovascular risk also exists in women. Maybe in the past it was considered that women were somewhat more protected from these diseases. Differences exist, however, that the speech should be addressed to prevent the same way as for men.
The important message is that cardiovascular disease can be prevented in both women and men. So
awareness of cardiovascular risk and other diseases, as seen in Mirella Taranto, in women, as humans, can automatically be associated with important preventive measures. All to try to avoid in future, the growing trend of increased mortality from cardiovascular causes and incidence of other diseases among women worldwide.
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