[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2130 Introduced in House (IH)]







105th CONGRESS
  1st Session
                                H. R. 2130

   To amend the Public Health Service Act to provide for expanding, 
intensifying, and coordinating activities of the National Heart, Lung, 
  and Blood Institute with respect to heart attack, stroke, and other 
                   cardiovascular diseases in women.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              July 9, 1997

   Ms. Waters (for herself, Mr. Ackerman, Mr. Boucher, Ms. Brown of 
 Florida, Ms. Christian-Green, Ms. Carson, Mrs. Clayton, Mr. Clyburn, 
  Mr. Conyers, Mr. Cummings, Mr. Davis of Illinois, Ms. DeGette, Mr. 
     Dellums, Mr. Engel, Mr. Evans, Mr. Faleomavaega, Mr. Fazio of 
   California, Mr. Filner, Mr. Frost, Mr. Gutierrez, Mr. Hastings of 
  Florida, Mr. Hilliard, Ms. Jackson-Lee of Texas, Ms. Eddie Bernice 
 Johnson of Texas, Mr. Kildee, Mr. Lewis of Georgia, Ms. Lofgren, Mrs. 
Lowey, Mrs. Maloney of New York, Mr. McDermott, Ms. McKinney, Mrs. Mink 
of Hawaii, Mrs. Morella, Ms. Norton, Mr. Payne, Ms. Pelosi, Ms. Rivers, 
 Ms. Roybal-Allard, Mr. Rush, Mr. Sanders, Ms. Slaughter, Mr. Stokes, 
Mr. Thompson, Mr. Towns, Mr. Underwood, Mr. Watt of North Carolina, Mr. 
  Clay, Mr. Clement, Mr. Dixon, Ms. Eshoo, Mr. Fattah, Mr. Flake, Mr. 
   Ford, Ms. Kilpatrick, Mrs. Kennelly of Connecticut, Mrs. Meek of 
  Florida, Ms. Millender-McDonald, Mr. Owens, Mr. Pastor, Mr. Romero-
   Barcelo, Mr. Scott, Mr. Serrano, Ms. Velazquez, Mr. Weygand, Ms. 
Woolsey, Mr. Waxman, Mr. Wynn, Mr. Barrett of Wisconsin, Mr. Capps, Mr. 
Delahunt, Mr. Sherman, Mr. Green, Mrs. Roukema, Mr. Jefferson, and Mr. 
   Matsui) introduced the following bill; which was referred to the 
                         Committee on Commerce

_______________________________________________________________________

                                 A BILL


 
   To amend the Public Health Service Act to provide for expanding, 
intensifying, and coordinating activities of the National Heart, Lung, 
  and Blood Institute with respect to heart attack, stroke, and other 
                   cardiovascular diseases in women.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Women's Cardiovascular Diseases 
Research and Prevention Act''.

SEC. 2. FINDINGS.

    The Congress finds as follows with respect to women in the United 
States:
            (1) Heart attack, stroke, and other cardiovascular diseases 
        are the leading causes of death in women.
            (2) Heart attacks and strokes are leading causes of 
        disability in women.
            (3) Cardiovascular diseases claim the lives of more women 
        each year than does cancer. Each year more than 500,000 females 
        die of cardiovascular diseases, while approximately 254,000 
        females die of cancer. Heart attack kills more than 5\1/2\ 
        times as many females as breast cancer. Stroke kills twice as 
        many females as breast cancer.
            (4) More than 1 in 5 females has some form of 
        cardiovascular disease. Of females under age 65, each year 
        approximately 20,000 die of heart attacks. In the case of 
        African-American women, from ages 35 to 74 the death rate from 
        heart attacks is 38 percent higher than that of white women.
            (5) Each year since 1984, cardiovascular diseases have 
        claimed the lives of more females than males. In 1993, of the 
        number of individuals who died of such diseases, 52 percent 
        were females and 48 percent were males.
            (6) The clinical course of cardiovascular diseases is 
        different in women than in men, and current diagnostic 
        capabilities are less accurate in women than in men. Once a 
        woman develops a cardiovascular disease, she is more likely 
        than a man to have continuing health problems, and she is more 
        likely to die.
            (7) Of women who have had a heart attack, approximately 44 
        percent die within 1 year of the attack. Of men who have had 
        such an attack, 27 percent die within 1 year. At older ages, 
        women who have had a heart attack are twice as likely as men to 
        die from the attack within a few weeks. Women are more likely 
        than men to have a stroke during the first 6 years following a 
        heart attack. More than 60 percent of women who suffer a stroke 
        die within 12 years. Long-term survivorship of stroke is better 
        in women than in men. Of individuals who die from a stroke, 
        each year approximately 61 percent are females. In 1993, 91,060 
        females died from strokes. Women have unrecognized heart 
        attacks more frequently than men. Of women who died suddenly 
        from heart attack, 63 percent had no previous evidence of 
        disease.
            (8) More than half of the annual health care costs that are 
        related to cardiovascular diseases are attributable to the 
        occurrence of the diseases in women, each year costing this 
        nation hundreds of billions of dollars in health care costs and 
        lost productivity.
            (9) A number of recent studies have found that hormone 
        replacement therapy contributes to the reduction of risk 
        factors for cardiovascular disease in postmenopausal women and 
        may reduce the risk of cardiovascular mortality in such women 
        by as much as 50 percent.

SEC. 3. EXPANSION AND INTENSIFICATION OF ACTIVITIES REGARDING HEART 
              ATTACK, STROKE AND OTHER CARDIOVASCULAR DISEASES IN 
              WOMEN.

    Subpart 2 of part C of title IV of the Public Health Service Act 
(42 U.S.C. 285b et seq.) is amended by inserting after section 424 the 
following section:

   ``heart attack, stroke, and other cardiovascular diseases in women

    ``Sec. 424A. (a) In General.--The Director of the Institute shall 
expand, intensify, and coordinate research and related activities of 
the Institute with respect to heart attack, stroke, and other 
cardiovascular diseases in women.
    ``(b) Coordination With Other Institutes.--The Director of the 
Institute shall coordinate activities under subsection (a) with similar 
activities conducted by the other national research institutes and 
agencies of the National Institutes of Health to the extent that such 
Institutes and agencies have responsibilities that are related to heart 
attack, stroke, and other cardiovascular diseases in women.
    ``(c) Certain Programs.--In carrying out subsection (a), the 
Director of the Institute shall conduct or support research to expand 
the understanding of the causes of, and to develop methods for 
preventing, cardiovascular diseases in women. Activities under such 
subsection shall include conducting and supporting the following:
            ``(1) Research to determine the reasons underlying the 
        prevalence of heart attack, stroke, and other cardiovascular 
        diseases in women, including African-American women and other 
        women who are members of racial or ethnic minority groups.
            ``(2) Basic research concerning the etiology and causes of 
        cardiovascular diseases in women.
            ``(3) Epidemiological studies to address the frequency and 
        natural history of such diseases and the differences among men 
        and women, and among racial and ethnic groups, with respect to 
        such diseases.
            ``(4) The development of safe, efficient, and cost-
        effective diagnostic approaches to evaluating women with 
        suspected ischemic heart disease.
            ``(5) Clinical research for the development and evaluation 
        of new treatments for women, including rehabilitation.
            ``(6) Studies to gain a better understanding of methods of 
        preventing cardiovascular diseases in women, including 
        applications of effective methods for the control of blood 
        pressure, lipids, and obesity.
            ``(7) Information and education programs for patients and 
        health care providers on risk factors associated with heart 
        attack, stroke, and other cardiovascular diseases in women, and 
        on the importance of the prevention or control of such risk 
        factors and timely referral with appropriate diagnosis and 
        treatment. Such programs shall include information and 
        education on health-related behaviors that can improve such 
        important risk factors as smoking, obesity, high blood 
        cholesterol, and lack of exercise.
    ``(d) Activities Regarding Hormone Replacement Therapy.--Activities 
carried out under subsection (c) shall include information and 
education programs for patients and health care providers on the 
benefits and risks of hormone replacement therapy and the role of such 
therapy in reducing the risk of cardiovascular disease in women.
    ``(e) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated $140,000,000 
for fiscal year 1998, and such sums as may be necessary for each of the 
fiscal years 1999 and 2000. The authorization of appropriations 
established in the preceding sentence is in addition to any other 
authorization of appropriation that is available for such purpose.''.
                                 <all>