Do we have new preventive strategies for optimizing cardiovascular health in women?

Over the past decades, progress in efforts to reduce cardiovascular morbidity and mortality has been achieved, although a disturbing trend for stagnation of cardiovascular mortality rates among younger women compared with those in younger men has been identified. While the menopause transition has traditionally offered an unequivocal opportunity to assess cardiovascular risk and counsel women to adopt preventive strategies, the veritable 'window of opportunity', usually applied to the concept of timing the initiation of menopausal hormone therapy, must be opened much wider to encompass younger women including those who have experienced adverse events during pregnancy, treatment for breast cancer, and premature menopause. Collaborative efforts by a number of expert medical groups provide encouragement and justification for an aggressive approach to identify and modify cardiovascular risk earlier in younger women, starting at age 20 years. Quantifying cardiovascular risk with country and population-specific risk calculators can be helpful to validate perception of risk and encourage preventive recommendations. Adherence to established guidelines for lifestyle measures (smoking cessation, healthful eating habits, enhanced physical activity, and weight control) along with treatment of traditional risk factors - hypertension, glucose intolerance, and dyslipidemia - provides a sound basis for prevention of cardiovascular disease in women.