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Women-specific predictors of cardiovascular disease risk - new paradigms
Silvia Maffei1, Letizia Guiducci2, Lucia Cugusi3
1Department of Gynecological and Cardiovascular Endocrinology, CNR-Tuscany Region, G. Monasterio Foundation, Pisa, Italy.
Insights
Cardiovascular disease (CVD) risk in women is linked to reproductive health. Gynecological conditions during fertile years and peri-menopause can signal future CVD, enabling early risk identification.
Area of Science:
- Reproductive Endocrinology
- Cardiology
- Women's Health
Background:
- Cardiovascular disease (CVD) is a major health concern for women, despite overall mortality reductions.
- While traditional risk factors apply, female-specific reproductive and gynecological factors are increasingly recognized as crucial for CVD risk assessment.
Purpose of the Study:
- To review pathological conditions in women's reproductive and peri-menopausal years that may increase cardiovascular disease risk.
- To highlight the importance of gynecological history in identifying women at elevated CVD risk.
Main Methods:
- Literature review of studies examining the association between gynecological and obstetric history and cardiovascular disease.
- Analysis of conditions such as polycystic ovary syndrome, premature ovarian failure, menopause, gestational diabetes, preeclampsia, and adverse pregnancy outcomes.
Main Results:
- Gynecological conditions and pregnancy complications are associated with increased CVD risk later in life.
- These conditions can serve as early indicators for identifying women susceptible to cardiovascular disease.
- Assessing gynecological history alongside conventional risk factors is vital for tailored prevention and treatment.
Conclusions:
- Gynecological and obstetric history provides critical insights into a woman's long-term cardiovascular risk.
- Early identification of CVD risk in women can be enhanced by incorporating reproductive health assessments.
- Personalized preventive and therapeutic strategies for CVD in women should consider their unique gynecological and reproductive profiles.
Abstract:
Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality in women in spite of the overall reduction in age-adjusted CVD mortality in the past few years. Although traditional risk factors for CVD are predictors of increased risk in both men and women, risk factors that are unique to women and related to their reproductive history have recently been considered to be important. The development of CVD in women may correlate with specific events taking place throughout a woman's obstetric and gynaecological history. Gynaecological conditions such as polycystic ovary syndrome, premature ovarian failure, surgical and spontaneous menopause, and conditions related to pregnancy, i.e. gestational diabetes, preeclampsia, intrauterine growth restriction, miscarriages, and preterm birth, may affect the onset, clinical features, and prognosis of CVD later in women's lives. These pathological conditions that develop during the fertile period of life or peri-menopause have been suggested to be early markers of future CVD; their presence presents a unique opportunity for the early identification of women who may be at an increased risk of CVD. The assessment of CV risk in women should not just focus on conventional risk factors but also on different aspects of the gynaecological history to allow specific preventive and therapeutic strategies to be established. This paper reviews the various pathological conditions occurring in women during their fertile period of life and peri-menopause, which have been identified to potentially increase CVD risk.
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