Graduation Semester and Year

2008

Language

English

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Nursing

Department

Nursing

First Advisor

Carolyn Cason

Abstract

Background: Coronary heart disease (CHD) continues to be a major public health problem and is the leading cause of death in the United States (US).The estimated cost of cardiovascular disease (CVD) and stroke in the US for 2007 was 431.8 billion dollars. CVD, including CHD and stroke, claims the lives of approximately 500,000 women a year, making it the number one killer of women in the United States and exceeds the number of deaths in men and the next 7 causes of death in women combined.Review of Literature: Few studies have been completed evaluating atherosclerosis, non-invasive cardiovascular testing, ethnic minorities and women. Despite the increased prevalence of cardiovascular risk factors and increased mortality in women, there are few studies that evaluate women and cardiovascular risk factors and interventions for heart disease among women.Methods and Design: A descriptive study design is the research design for this study. Eighty four pre-menopausal Hispanic between the ages of 25 -45 completed coronary computed tomography angiography (CTA) to assess for presence of soft and hard atherosclerosis. The four outcomes measures evaluated were coronary plaque accumulation, cholesterol components, body mass measurement and waist circumference.Results: Coronary CTA was normal for 83 women. In only one case, coronary CTA revealed a non-obstructive <20% soft plaque accumulation in the proximal left anterior descending artery. Fifty percent of these women had undesirable low density lipoproteins (LDL) and high density lipoproteins (HDL) levels that should be treated but only 6% were on treatment for dyslipidemia. Fifty six percent of the women had BMIs > 24.9 with some form of dyslipidemia. Eighty one percent of the women had waist circumferences > 35 inches. Even though only one woman demonstrated a non-obstructive coronary plaque, 70% of these women had a metabolic syndrome (MS) which is manifested by 3 of 5 CVD risk factors: hypertension, elevated glucose levels, hypertriglyceridemia, HDL <50 mg/dL and an increased abdominal girth.Summary: Despite having at least 3 CVD risk factors, one pre-menopausal Hispanic woman had coronary plaque. Seventy percent of woman had MS suggesting these women have a trajectory toward the development of coronary plaque formation and CVD in the future.

Disciplines

Medicine and Health Sciences | Nursing

Comments

Degree granted by The University of Texas at Arlington

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