Por Mildren del Sueldo
Hoy sabemos que hay FR tradicionales y no tradicionales únicos o específicos. Los FR tradicionales y por todos conocidos pueden afectar de manera diferente a la mujer, o ser mas prevalentes. Por ejemplo la Diabetes y el tabaquismo aumentan mucho mas el riesgo de presentar un evento cardiovascular en la mujer que en el hombre. La Hipertensión arterial después de los 60 años es mas prevalente en la mujer y es mucho mas difícil de lograr su control, y esto solo para nombrar alguna de las tantas diferencias que hoy conocemos.
Pero a su vez nosotras presentamos factores de riesgo cardiovascular únicos o no tradicionales ya que tienen que ver con la propia esencia de ser mujer. Es por esto que en una mujer es importante investigar sus embarazos, si fueron normales o no. Hoy sabemos que tener Hipertensión durante el embarazo, diabetes gestacional, Embarazos prematuros, Menarcas o primera menstruación tempranas o tardías (antes de los 12 o después de los 15 años), no recuperar el peso que teníamos antes de embarazarnos entre los 3 a 12 meses posteriores a tener a nuestro bebe, son condiciones que aumentan el riesgo cardiovascular en el futuro.
También las enfermedades autoinmunes como la Artritis reumatoidea o el Lupus no solo son mucho mas frecuentes en la mujer, sino que multiplican por 3 a 9 el riesgo de infarto o accidente cerebrovascular. Cada vez mas son las mujeres sobrevivientes a algún tipo de cáncer, fundamentalmente el de Mama que es el cáncer mas frecuente en nosotras. Hoy también sabemos que toda mujer sometida a radioterapia mediastinica o quimioterapia debe ser incluida en un programa de vigilancia de riesgo cardiovascular a largo plazo.
El STRESS es mas prevalente en la mujer, también en Villa María realizamos una encuesta en donde a través de una escala que se va completando podemos definir si hay stress o no, y este era mucho mas prevalente en la mujer que en el hombre (55% vs 24%). Además no solo es mas frecuente sino que lo vivimos diferente, en un estudio que se hizo hace varios años midiendo las sustancias del stress que son las epinefrinas, se puede ver como el hombre hace un pico de ellas cuando llega a su trabajo, luego este baja, tiene un leve aumento en las primeras horas de la tarde para después al retornar a su hogar bajar definitivamente. La mujer en cambio hace el primer pico al llegar a su trabajo, pero luego cuando retorna al hogar vuelve a ser otro pico, en ocaciones superior al que hizo en el trabajo. Esto se explica porque la mujer que hoy trabaja (la gran mayoría) no puede dejar de lado todas aquellas acciones que por genero le corresponden como son las responsabilidades del hogar y llegar a él después de 8 hs de ausencia le genera preocupación y stress.
El riesgo de ECV en la mujer incrementa después de la menopausia, situación que en la actualidad no se le adjudica a los cambios hormonales únicamente y está en continua revisión. Considerando que la expectativa de vida de la mujer se ha prolongado, se proyecta que para el año 2030 en el mundo, habrá 1200 millones de mujeres mayores de 50 años con lo cual deben implementarse estrategias de promoción y prevención de la salud para que la mujer llegue a la menopausia lo mas saludable posible. Mucho se avanzo en la prevención y el control del Cáncer de Mama y hoy la mayoría de las mujeres saben que se tienen que hacer una mamografía de control anual y acudir a la consulta ginecológica. Con respecto a la ECV también en los últimos años debido a una mayor sensibilidad y preocupación por parte de los profesionales y sociedades científicas como la Federación Argentina de Cardiología, la Sociedad Argentina de Cardiología, la Sociedad Europea de Cardiología, la American Heart Asssociation y otras, se han promovido campañas de difusión tanto a nivel profesional como poblacional, actualmente en marcha, que con toda seguridad, fomentaran el conocimiento y cambiaran la actitud frente a este grave problema sanitario. También estamos trabajando en la creación de un día icono que simbolice la lucha contra esta enfermedad, reforzando en ese día el mensaje de que la mujer debe cuidar su salud cardiovascular, proyecto que ya fue presentado en la Honorable Cámara de Diputados de la Nación. Este año desde la Federación Argentina de Cardiología decidimos unirnos a otras entidades y empresas con responsabilidad social como fundación ESSEN, MCI, etc, para lograr transmitir este mensaje y llegar a todas las mujeres argentinas.
Empoderar a la Mujer con conocimiento
El conocimiento es poder!!. La educación en salud es clave y si bien hace 10 años que venimos trabajando en el tema, sentimos que nos falta mas, sentimos que aun queda un gran número de mujeres argentinas que no ven a la Enfermedad cardiovascular y sus factores de riesgo como una amenaza. Así nace esta nueva campaña “Cuido mi corazón” cuyo objetivo es empoderar a la mujer con conocimiento, con saber hacer, con saber cuidar, entendiendo también que trabajar sobre la mujer es trabajar sobre la familia, sobre los niños y el introducir hábitos saludables en la temprana edad es no solo trabajar en el hoy, sino también en el mañana. Es trabajar para tener hombres y mujeres cada vez mas sanos y educados en salud cardiovascular.
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