More than half of American women are unaware that cardiovascular disease is the nation's No. 1 killer of women, according to a new national survey published by Dr. Lori Mosca, associate professor of medicine and director of preventive cardiology at NewYork-Presbyterian Hospital.

"There's still a large information gap that we need to close to reduce the burden of cardiovascular disease in our society," Dr. Mosca says. "The percentage of women who know that cardiovascular disease is their leading cause of death grew from 30 percent in 1997 to 46 percent in 2003, but we still have a long way to go."

Dr. Mosca also chaired an expert panel that published the first evidence-based guidelines for cardiovascular disease prevention in women, based on an extensive search and review of 7,000 studies, to help women and their doctors prevent heart disease in women. Both appeared in the Feb. 10 issue of Circulation, the journal of the American Heart Association.

The survey also showed that women do not know their risk factor levels. About 70 percent did not know their "good" and "bad" cholesterol levels.

"Awareness of personal risk is the first step," Dr. Mosca says. "If you're not aware, you're not going to take action."

Dr. Mosca recommends using the Framingham Risk Assessment Calculator to calculate risk and recommends that women discuss the results with their doctors. Though the vast majority of the women in the survey said they felt comfortable talking with their doctors, only 38 percent had had a discussion about heart disease.

The guidelines also listed three interventions that should be avoided by women – postmenopausal hormone therapy, antioxidant supplements, and aspirin for low-risk patients – because research hasn't shown these treatments to be effective and they may be harmful.

The research was funded by the American Heart Association and the Foundation for the Advancement of Cardiac Therapies.