Understanding the spectrum of cardiovascular risk in women - A primer for prevention

Area of Science:

• Cardiology
• Women's Health
• Preventive Medicine

Background:

• Cardiovascular disease (CVD) is the primary cause of death for women globally, with a lifetime risk comparable to men.
• Historical underrepresentation in research has led to gaps in understanding CVD prevention and management specific to women.
• Traditional CVD risk factors affect women differently than men, and unique sex-specific and pregnancy-related factors also influence risk.

Purpose of the Study:

• To highlight the necessity of sex-specific approaches to cardiovascular (CV) risk assessment and management in women.
• To discuss the evolving understanding of CVD risk factors in women, including traditional, sex-specific, and pregnancy-related factors.
• To review implementation strategies for optimizing CVD risk reduction and mitigating outcome disparities in women.

Main Methods:

• Review of current literature on sex differences in CVD pathophysiology and risk factors.
• Analysis of the limitations of traditional CVD risk calculators in women.
• Discussion of emerging tools like risk enhancers and coronary artery calcium scoring for improved risk stratification.

Main Results:

• Traditional risk factors have differential impacts on CVD risk in women compared to men.
• Sex-specific and pregnancy-related factors are crucial predictors of future CVD in women.
• Standard risk calculators often misclassify risk in younger women, particularly those with nontraditional risk factors.

Conclusions:

• Implementing risk enhancers and coronary artery calcium scoring can refine CVD risk assessment in women.
• Addressing disparities requires tailored strategies for CVD prevention and management, acknowledging sex-specific nuances.
• Optimizing CVD risk in women necessitates a comprehensive, sex-specific approach integrating novel assessment tools and risk factors.