The role of nurse practitioners in primary care in optimizing risk stratification for coronary heart disease in Canadian women: an integrative review

Coronary heart disease (CHD) is the most common cause of morbidity and mortality in Canadian women. Despite advances in screening and research, CHD continues to pose a significant health care burden to Canadian women. This integrative literature review explores how a Nurse Practitioner (NP) in primary care can optimize risk stratification for CHD in Canadian women. A systematic search of the contemporary literature identified 11 key articles. These were analyzed using the Critical Appraisal Skills Programme tools to assess relevance and the strengths and weaknesses of the evidence. Three key themes emerged from the literature and are explored in detail: the limitations of current risk prediction models for risk stratification in women; the emergence and evolving importance of female-specific risk factors; and additional adjunctive testing (coronary artery calcium screening) that may improve the accuracy of risk prediction models in women. ...