Coronary heart disease risk factors in women: focus on gender differences

Cardiovascular disease is the leading cause of death in Louisiana and in the United States. Louisiana women have the second highest mortality rate for cardiovascular disease in the country. The major risk factors in both men and women include cigarette smoking, hypertension, dyslipidemia, diabetes mellitus, obesity, sedentary lifestyle, and poor nutrition. A body of evidence is accumulating to support the existence of nontraditional risk factors such as elevated homocysteine levels and antioxidants. Gender-specific risks and interventions also exist in the form of oral contraceptives and hormone replacement therapy respectively. Raloxifene and other selective estrogen receptive modulators may alter the regimens of hormone replacement therapy in the future. This article reviews cardiac risk factors focusing on gender differences, the arguments for and against hormone replacement therapy as it relates to coronary disease, and some practical aspects of hormone replacement therapy that physicians encounter when considering hormone replacement therapy in the postmenopausal woman.