July 14, 2023

Reps. Sykes, Cammack, Lee, And De La Cruz Lead Bipartisan Letter To HHS Secretary To Prioritize Women’s Cardiovascular Health

WASHINGTON, D.C. — U.S. Representative Emilia Strong Sykes (OH-13), Co-Vice Chair of the Bipartisan Women’s Caucus, joined by Bipartisan Women’s Caucus Co-Chairs Representatives Kat Cammack (FL-03) and Susie Lee (NV-03), and Co-Vice Chair Representative Monica De La Cruz (TX-15), led a bipartisan letter to U.S. Health and Human Services Secretary Xavier Becerra, calling for the prioritization of women’s cardiovascular health.

“Cardiovascular disease (CVD) is the number one killer of all. While many heart attacks, strokes, and deaths caused by CVD are preventable, the widespread lack of CVD awareness and subsequent lack of screening, diagnosis and treatment only broaden the impact this disease has on women,” wrote the signers. “All women deserve quality cardiovascular care with a focus on prevention, which includes access to innovative treatments when needed. Special attention should be focused on the disparities that exist among racial and ethnic groups. According to a report published by the American Heart Association, non-Hispanic Black women are more likely to suffer from CVD than their non-Hispanic White female peers. Between 2015 and 2018, the alarming prevalence of CVD was 42.1 percent in non-Hispanic white women, 42.7 percent in Hispanic women, and 58.8 percent in non-Hispanic Black women aged 20 years or older.”

“The Association of Black Cardiologists commends this bipartisan effort to address the critical issue of women's cardiovascular health, particularly among communities of color. The staggering prevalence of cardiovascular disease among women, coupled with the significant disparities in screening, diagnosis, and treatment, demands immediate attention and action. We stand united in our call to prioritize comprehensive care, early intervention, and equitable access to life-saving treatments, ensuring that no woman falls victim to the leading cause of death in our nation,” said Dr. Anekwe Onwuanyi, President, the Association of Black Cardiologists.

“We support this bipartisan call to prioritize women's cardiovascular care. The documented disparities in screening, treatment adherence, and access to innovative therapies such as PCSK9 inhibitors underscore the urgent need for action. Our work champions comprehensive care by eliminating barriers to life-saving treatments, and with greater support from Secretary Becerra and HHS leadership, we believe we can significantly reduce the risk of heart attacks and improve the health outcomes of women across the nation,” said Ryan Gough, Executive Director, the Partnership to Advance Cardiovascular Health.

This letter has also been endorsed by the American Heart Association.

The full letter is below and linked here.

June 30, 2023

The Honorable Xavier Becerra

Secretary

U.S. Department of Health and Human Services

200 Independence Avenue SW

Washington, DC 20201

Dear Secretary Becerra,

We write to urge you to prioritize women’s cardiovascular health, as cardiovascular disease (CVD) is the leading cause of death among women in the United States, responsible for 1 in 5 female deaths.[1] For women over the age of 25, CVD is the number one killer for women of all races.[2] While many heart attacks, strokes, and deaths caused by CVD are preventable, the widespread lack of CVD awareness and subsequent lack of screening, diagnosis and treatment only broaden the impact this disease has on women. Women’s awareness of CVD has declined by approximately 20 percent in the last decade, most significantly among younger women.[3] In fact, most women incorrectly identify cancer, rather than CVD, as the leading cause of death among females.

As a key step in preventing heart attacks and strokes, factors contributing to CVD must be identified and treated much earlier. For example, more than 200 studies with over 2,000,000 patients have broadly established that elevated LDL-cholesterol levels unequivocally cause atherosclerotic cardiovascular disease (ASCVD),[4] which is responsible for nearly 85 percent of cardiovascular deaths. The American Heart Association recommends that adults 40 and over should have their LDL-cholesterol levels tested every five years and their 10-year risk of stroke or heart attack calculated regularly to better inform disease management decisions, and that primary care physicians should test for CVD.[5] Widespread adoption of these and similar recommendations for other CVD risk factors could diagnose and treat heart disease earlier and prevent devastating cardiac events for the approximately 300,000 women that die from the disease every year.[6]

In addition, new data show that there is a gap in essential care for Medicare beneficiaries who have had a heart attack. For example, less than 30 percent of Medicare Fee-for-Service beneficiaries’ LDL-C levels were tested in the 90 days after being hospitalized due to a heart attack, despite clinical guidelines recommending earlier and more frequent LDL-C testing to monitor and manage one’s cholesterol levels.[7] In fact, a third of those survivors did not receive an LDL-C test in the full year following their heart attack.[8] The importance of timely LDL-C testing cannot be overstated as patients who fail to reach goal LDL-C levels are at a 44.2 percent higher risk of incurring a cardiovascular event.[9] A leading group of cardiologists have called for a national performance metric for LDL-C control to help close this quality gap as well as to reduce healthcare disparities.[10]  

  

All women deserve quality cardiovascular care with a focus on prevention, which includes access to innovative treatments when needed. Special attention should be focused on the disparities that exist among racial and ethnic groups. According to a report published by the American Heart Association, non-Hispanic Black women are more likely to suffer from CVD than their non-Hispanic White female peers. Between 2015 and 2018, the alarming prevalence of CVD was 42.1 percent in non-Hispanic white women, 42.7 percent in Hispanic women, and 58.8 percent in non-Hispanic Black women aged 20 years or older.[11] Furthermore, Black and Hispanic women are less likely to be screened for CVD, or adhere to prescribed preventive therapies, like statins for cholesterol control, in the year following a heart attack compared to their non-Hispanic White counterparts[12] demonstrating a need for targeted efforts to improve the quality, coordination, and continuity of care in these populations. Additionally, access to medications such as cholesterol lowering PCSK9 inhibitors, which can decrease LDL-C by up to 70 percent and reduce the risk of a heart attack by almost one-third continue to be a disproportionate hurdle for Black and Hispanic women.

We urge you to prioritize outreach to Medicare beneficiaries and healthcare providers to periodically inform them of the preventive benefits provided by Medicare and relevant national coverage decisions that support access to cardiovascular health care. We must also recognize the importance of routine lipid screening and management as a critical piece of the puzzle while we work to significantly lessen the incidence of cardiac events in women.

Thank you for your attention to this important matter. We look forward to working with you to make women’s heart health a priority and to close the gap in diagnosis and treatment for the number one killer of women.                                                                                  

Emilia Strong Sykes                                                               Kat Cammack

Member of Congress                                                              Member of Congress

13^th Congressional District of Ohio                                        3^rd Congressional District of Florida

Co-Vice Chair                                                                         Co-Chair

Bipartisan Women’s Caucus                                                  Bipartisan Women’s Caucus                               

Susie Lee                                                                                Monica De La Cruz    

Member of Congress                                                              Member of Congress

3^rd Congressional District of Nevada                                     15^th Congressional District of Texas 

Co-Chair                                                                                 Co-Vice Chair

Bipartisan Women’s Caucus                                                  Bipartisan Women’s Caucus

Organizational Support:

The American Heart Association

The Partnership to Advance Cardiovascular Health

The Association of Black Cardiologists

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