Copyright © 1996 by the European Society of Cardiology.
© 1996 1996 The European Society of Cardiology
Risk factors for cardiovascular disease in women: Assessment and management
Department of Cardiology, Karolinska Hospital Stockholm, Sweden
Correspondence Dr Karin Schenck-Gustafsson, Associate Professor, Department of Cardiology, Karolinska Hospital, Box 110, Stockholm, Sweden, S-171 76
Coronary heart disease (CHD) is the most important cause of death and disability among older women. A 50-year-old woman has a 46% risk of having CHD and a 31% risk of dying from it. Female CHD patients have a distinct clinical presentation, which includes more severe thromboembolic disease without coronary arteriosclerosis. Syndrome X also appears to be more prevalent in women. Oestrogen deficiency may be a trigger for this syndrome. The magnitude of the effect of various risk factors may also differ between women and men. In addition, there are risk factors unique to women. Lipid profiles differ between men and women. After menopause, the lipid profile changes unfavourably, with increasing levels of LDL cholesterol and decreasing levels of HDL cholesterol. Cigarette smoking, hypertension, diabetes mellitus, and obesity are all recognised risk factors for CHD in women.
It is important to recognise that risk factors for CHD differ between men and women. Advising women to quit cigarette smoking, avoid obesity, increase physical activity, and prevent and treat hypertension and hyperlipidaemia will result in a reduction in CHD risk. Additional studies are needed to further contribute to our understanding of the complex risk factors underlying the development of CHD in women.
Key Words: Coronary artery disease (CAD) • risk factors • oestrogen replacement therapy • oestrogen