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Sex-specific differences in cardiovascular risk factors and implications for cardiovascular disease prevention in
Aardra Rajendran1, Anum S Minhas2, Brigitte Kazzi1
1Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Insights
Cardiovascular disease (CVD) is a major global health concern for women. Comprehensive risk assessment must include female-specific factors beyond traditional ones to guide preventive strategies.
Area of Science:
- Cardiology
- Women's Health
- Preventive Medicine
Background:
- Cardiovascular disease (CVD) is the primary cause of death for women worldwide.
- Traditional CVD risk factors (diabetes, hypertension, obesity, smoking) exhibit sex-specific risk differences.
- Unique female-specific factors (e.g., polycystic ovary syndrome, adverse pregnancy outcomes) significantly impact women's cardiovascular risk.
Purpose of the Study:
- To review sex differences in traditional cardiovascular risk factors.
- To highlight female-specific and female-predominant conditions that increase CVD risk.
- To emphasize the importance of incorporating these factors into cardiovascular risk assessment for women.
Main Methods:
- Review of existing literature on sex differences in CVD risk factors.
- Analysis of female-specific risk factors across the lifespan.
- Examination of the utility of coronary artery calcium scores and biomarkers for risk stratification.
Main Results:
- Traditional risk factors have varying impacts on cardiovascular risk between sexes.
- Female-specific factors like autoimmune diseases, migraines, and pregnancy complications elevate CVD risk.
- Ascertaining these factors enables identification of high-risk women for targeted interventions.
Conclusions:
- A holistic cardiovascular risk assessment for women must integrate both traditional and female-specific factors.
- Early identification of elevated risk allows for intensified preventive measures, including lifestyle modifications and pharmacotherapy.
- Further research into risk stratification tools like coronary artery calcium scores is crucial for personalized preventive cardiology in women.
Abstract:
Cardiovascular disease (CVD) is the leading cause of mortality for women globally. Sex differences exist in the relative risks conferred by traditional CVD risk factors, including diabetes, hypertension, obesity, and smoking. Additionally, there are female-specific risk factors, including age of menarche and menopause, polycystic ovary syndrome, infertility and the use of assisted reproductive technology, spontaneous pregnancy loss, parity, and adverse pregnancy outcomes, as well as female-predominant conditions such as autoimmune diseases, migraines, and depression, that enhance women's cardiovascular risk across the lifespan. Along with measurement of traditional risk factors, these female-specific factors should also be ascertained as a part of cardiovascular risk assessment to allow for a more comprehensive overview of the risk for developing cardiometabolic disorders and CVD. When present, these factors can identify women at elevated cardiovascular risk, who may benefit from more intensive preventive interventions, including lifestyle changes and/or pharmacotherapy such as statins. This review describes sex differences in traditional risk factors and female-specific/female-predominant risk factors for CVD and examines the role of coronary artery calcium scores and certain biomarkers that can help further risk stratify patients and guide preventive recommendations.
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