AJN On the Cover
On our cover this month is a lithograph titled A Map of the Open Country of a Woman's Heart. First printed in the 1830s by the D.W. Kellogg firm of Hartford, Connecticut, it was issued as one of a pair, accompanied by A Map of the Fortified Country of a Man's Heart. The artist responsible for the image claims to be “A Lady,” but it is just as likely that this “map” was created by a man. Although the illustration captures outdated 19th-century ideas about women, they're depicted with a layer of humor that wouldn't have been lost on its audience.
According to this lithograph, love is at the center of a woman's heart, and sentiment, coquetry, and selfishness take up a sizeable portion. This style of allegorical map of the human condition came of age during the late Renaissance, when it was known as “sentimental cartography.” The images focus on capturing the sensibilities of the era, and the style would have been familiar to viewers of the period.
While we can be glad that most of society has progressed beyond such patronizing views of women, when it comes to the health of real women's hearts, women are still often misunderstood—even by women themselves. In 2008, one in three women in the United States died from cardiovascular disease (CVD), yet recent surveys by the American Heart Association (AHA) show that women continue to underestimate their true risk of CVD. This was one of the reasons prompting the AHA to update its 2007 guidelines for preventing CVD in women and why it's important that nurses be aware of the revisions and the reasons behind them. Among the 2011 updates are the following:
The focus of the guidelines has shifted from “evidence based” to “effectiveness based.”
The category formerly called “optimal risk” is now referred to as “ideal cardiovascular health,” defined in terms of both ideal health behaviors (such as smoking abstinence) and ideal health factors (such as untreated blood pressure below 120/80 mmHg).
“High risk” is now defined as having a 10% or greater 10-year risk of any CVD.
A history of preeclampsia, gestational diabetes, or pregnancy-induced hypertension may put women at risk for CVD.
For our report on the new guidelines, see “Update on Cardiovascular Disease Prevention in Women” in this issue.—Michael Fergenson, senior editorial coordinator