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110: Women Veterans' Health Behaviors, Life Events and Cardiovascular Disease Risks: Targets for Care Innovation

Bean-Mayberry BA, Chanfreau CC, Schweizer CA, Dyer KE, Brunner JW, Saifu HN, Moreau JL, Huynh AK, Moin T, Finley E, Hamilton AB, Farmer Coste MM. 110: Women Veterans' Health Behaviors, Life Events and Cardiovascular Disease Risks: Targets for Care Innovation. [Abstract]. Clinical Cardiology. 2019 Nov 8; 42(Suppl 2):S36-S50.


Background/Synopsis: One in three American women die of cardiovascular disease (CVD) annually, and extensive evidence shows that lifestyle behaviors, environmental exposures, and mental illness contribute detrimentally to CVD risk. Objective/Purpose: The objective of this analysis was to examine characteristics of women Veterans who indicated interest in CVD risk reduction. Methods: Across three VA primary care clinics, we surveyed women Veterans exposed to at least one component of a CV toolkit designed to increase patient engagement and reduce CV risk. The survey included measures of health behaviors, traumatic life events, and depression, as well as past VA care, VA provider trust, and delaying care in the past year. Results: Among 85 respondents (average age 60, range 29-86), 96% reported at least one CV risk factor, and 59% had 4+ risks. Regarding health behaviors within this group, 48% had ever smoked cigarettes, 9% currently smoked, 13% had tried e-cigarettes with 2% currently using, 9% had used drugs for non-medical purposes, and 13% reported alcohol misuse. Regarding trauma exposures, 36% reported unwanted or attempted sexual contact and 60% reported experiencing at least one traumatic event (e.g., earthquake/flood, seeing a death/injury, physical or sexual abuse, etc.). More than half (58%) reported a depression history. Most (79%) reported using VA care for 6-20+ years. Trust in VA primary care providers was high (mean 9 [SD 1.9] range 1-10), yet 28% reported delaying or going without needed care recommended by their VA provider. Conclusions: Nearly all women had a CVD risk factor, and over half reported depression and trauma. However, current smoking and alcohol use classic markers of CVD risks were not highly prevalent. Despite lengthy tenure of VA care and extremely high provider trust ratings, one-quarter of women reported not getting recommended care, suggesting that women with complex histories may have difficulties trying to reduce CVD risks.

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