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Friday, March 24, 2023

Heart Disease and Women

Cardiovascular diseases are the leading cause of morbidity and mortality among women. The pathophysiological basis of cardiovascular health among men and women is not identical. This leads to variable cardiovascular responses to stimulus and presentation of cardiovascular disease symptoms, both of which can have a direct effect on treatment outcomes.

Traditionally, the enrollment of women in clinical trials has been minimal, resulting in a lack of gender-specific analysis of clinical trial data and, therefore, the absence of concrete risk factor assessment among women. However, scientific progress in the past decade has identified a spectrum of risk factors for cardiovascular diseases that may be specific to women. These risk factors, which may include menopause, hypertensive disease of pregnancy, and depression, confer additional risk in women besides the traditional risk factors. Therefore, although the treatment of cardiovascular diseases is similar in both genders, appropriate risk stratification may be limited in women compared to men.

Assessment and prevention strategies should start early in a woman’s life. Although there is no set age for this assessment to occur, ideally it should start at the onset of adulthood when modifications at this time will have lasting benefit on the slow-growing nature of atherosclerosis. Brown and colleagues acknowledged the importance of the recommendations from The American College of Cardiology/American Heart Association (ACC/AHA) to screen adults between ages 20 and 79 to assess for the CVD risk factors such as smoking, hypertension, diabetes mellitus, total cholesterol, and HDL-C.6 This assessment should be repeated every 4 to 6 years, and sooner if risk factors are abnormal.

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