CONGRESS ABSTRACT

Anxiety and depression are recognized in the literature as a cardiovascular risk factor for women, yet they are still too little investigated and then undertreated. The variety of clinical presentations of ischemic heart disease in women is well known. Too many women are still labeled by doctors as anxious and discharged with neither a diagnosis nor a therapeutic indication. A gender cardiology outpatient clinic has been active in our Operative Unit since 2014 Anxiety and depression are emerging elements in these patients. We conducted a survey on the psychological well-being of these patients.  Out of 17 women 23.5% was diagnosed with depression or anxiety, 58.8% had 2 or more concomitant disorders commonly associated with depression. The most common were: sleep disturbances, guilt and inadequacy feelings , lack of energy and excessive fatigue, changes in appetite. These data are insufficient for a diagnosis of mood disorder, but suggestive of a hidden need for health. We also conducted a survey during a conference on gender cardiology for a general audience, with questions on cardiovascular risk factors, including anxiety and depression. The respondants were  women over 65. 12 out of 35 (34%) declared the presence of anxiety and/or depression, of these only 33% in therapy. The group with anxiety and depression (I) had a slightly worse cardiovascular risk profile, with on average 3 concomitant risk factors, compared to 2.5 in the second group (II), excluding menopause present in all. In particular: hypertension (75% in I, 39% in II), all treated; dyslipidemia (75% I, 65% II), 50% treated in group I and 60% in II; diabetes only 1 in group I and 6 (26%) in II; overweight (66% I and 39% II). No one with complications in pregnancy, smoking almost absent. Autoimmune and rheumatological diseases and polycystic ovary were scarcely present in this sample. In our clinic emotions related to bereavement, violence and complex social situations have often emerged for the first time. Communicating  these emotions, is the first step, even during a cardiology visit, to embark on the path to treatment. Our allies must be empathy and time. For a woman, anxiety and depression must not be labels that preclude a heart disease diagnosis; as other risk factors, they must be sought and taken care of,  to better treat the associated heart disease or prevent its onset.