• Improving diagnosis , because 20% to 40% of heart attacks occur in patients previously undiagnosed with CVD. 90 Women with CVD in particular continue to be under-diagnosed and under-treated due to misconceptions and lack of awareness among patients and doctors. 91 Employers should encourage escmrepelonyineegsattoohnasvitee awperlilmneasrsyecvaernetsp.rovider and include blood pressure • Increasing use of and adherence to proven first-line treatments . Low- cost generic drugs are effective for most patients with CVD when used appropriately, reducing out-of- pocket costs for patients and health plans. But adherence to treatment is far from ideal. Compared to men, women have hb ei gchaeurs er i os kf ifnocrrme aesdeidc asttiaotni nnionnt o- al edrhaenrceen oc er , ae lsopwe ceira pl l ey rfcoerpstti ao tni nosf. CTVhDi s rmi saky b e in women. 92 • Decreasing financial obstacles to use of advanced treatments . For some pb ua tt i ne no tt su, tsipl iezceida .l iFzoerd ecxaarmd ipolvea, sPcCuSl aKr9t ihnehr iabpi ti eosr sa na rde i na tfeorrvme notfi oc nh so laerset enreoel -d e d lowering drug used for patients that cannot tolerate statins. Most health plans rpeaqt iueinr et spwr eear ue tdheonr ii ez da t, iaonndf oo rf tPhCoSsKe 9wi nh oh i wb iet or er sa; popnreo va en da ,l y1s5i s%f onuenvde rt hf ial ltemd at hn ey i r prescription, possibly because of high co-pays. 93 • Providing benefits that support end-stage heart failure . Most patients with sc eo rs itol yu sf ohr etahret hf aeial ul trhec da iree isny st ht eemh.oPs aplilti aa lt,i vwehci ca hr ei sa ns tdr ehsosmf uel fhoeratl ht he appapt ireonatcahneds could improve the end-of-life patient experience and lower costs. Address the Underuse of Effective Diabetes and Obesity Treatments Effectively treating diabetes and obesity is important in reducing CVD risk. Re- moving or reducing financial barriers like high deductibles and out-of-pocket cost sharing increases the likelihood that women and family members will ob- tain treatment. It has also been shown to improve medication adherence, reduce health care spending and mitigate health disparities among certain racial and ethnic groups, including Black and Hispanic people. 94
90 https://pubmed.ncbi.nlm.nih.gov/24811552/ 91 https://world-heart-federation.org/what-we-do/women-cvd/ 92 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7606362/ 93 https://www.cardiosmart.org/news/2019/8/strict-insurance-policies-reduce-access-to-life-saving-cholesterol-drugs 94 https://www.healthaffairs.org/do/10.1377/hblog20210902.136368/full/
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