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Published on: August 13, 2019
Prevention of cardiovascular disease in women
Anthony A Bavry1, Marian C Limacher1
1Department of Medicine, University of Florida, Gainesville, Florida.
Insights
Cardiovascular disease (CVD) is a leading cause of death in women. Accurate risk assessment is crucial for women to identify eligibility for preventive measures and therapies like aspirin.
Area of Science:
- Cardiology
- Preventive Medicine
- Women's Health
Background:
- Cardiovascular disease (CVD) is the primary cause of mortality in women, surpassing men.
- Many women, particularly minority women, lack awareness regarding CVD risks and prevention.
- Accurate CVD risk estimation is vital for all women, regardless of prior history, to guide preventive strategies.
Purpose of the Study:
- To emphasize the importance of cardiovascular disease risk assessment in women.
- To highlight preventive measures and therapeutic options for cardiovascular disease in women.
- To discuss the current recommendations regarding hormone therapy and folic acid for cardiovascular disease prevention.
Main Methods:
- Utilized data from the Framingham Heart Study to develop a widely used risk score.
- Acknowledged the availability of multiple cardiovascular disease risk assessment tools.
- Reviewed lifestyle modifications and pharmacological interventions for cardiovascular disease prevention.
Main Results:
- Cardiovascular disease mortality rates are higher in women than in men.
- Risk scores aid in determining the need for preventive measures and therapies like aspirin.
- Lifestyle factors such as smoking cessation, healthy weight, diet, physical activity, and controlled blood pressure/cholesterol are key to prevention.
Conclusions:
- Aspirin may offer benefits for primary prevention of ischemic stroke but requires balancing against bleeding risks.
- Hormone therapy is not recommended for cardiovascular disease prevention due to increased adverse events, including stroke risk.
- Folic acid supplementation is no longer advised for cardiovascular disease prevention due to a lack of demonstrated benefit.
Abstract:
Cardiovascular disease is the leading cause of death among women. In fact, the cardiovascular disease mortality rate among women exceeds the rate in men. Unfortunately, many minority women are still unaware of the importance of this disease. All women, including those with no history of cardiovascular disease, should have an accurate estimate of the probability of a cardiovascular disease event (death, myocardial infarction, or stroke) usually within the next decade. Such an estimate will help determine if women are candidates for preventive measures and specific therapies such as aspirin. Data from the Framingham Heart Study were used to construct a risk score, which is now widely used; however, other risk scores are available. To prevent cardiovascular disease, women should refrain from smoking, maintain a healthy weight, eat a heart-healthy diet, be physically active, and have normal blood pressure and cholesterol levels. Aspirin can be considered for primary prevention, with expected benefit to prevent ischemic stroke; however, this needs to be balanced against potential bleeding risk. Hormone therapy is no longer recommended due to an increase in adverse events (most consistently seen as increased ischemic stroke risk). Folic acid is also no longer recommended due to lack of benefit.
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