Is Cardiovascular Disease in Women Inevitable?

Abstract

Cardiovascular disease (CVD) is the leading cause of death for American women. Women share many of the same risk factors (RFs) for CVD as men, and in both, women and men, these RFs are associated with age. Additionally, the prevalence of multiple RFs increases with age. Though menopause has been thought to increase CVD risk in women, the association between menopause and age obfuscates a causal relationship. While men's CVD mortality has decreased since the 1980s, women's CVD mortality has climbed until 2000. This has resulted in a sex-related CVD mortality gap, with women having higher mortality than men since 1984. Contributing to this female-majority CVD mortality gap is a lack of awareness of CVD risk among women and their physicians. Awareness campaigns, such as the Heart Truth and the Red Dress symbol, appear to have improved recognition of CVD risk in women. Further, female-specific guidelines have been developed to prevent and reduce CVD in women. Though the current understanding of the role of menopause in CVD is controversial, studies suggest that menopause does not exacerbate CVD independent of aging, and hormone replacement therapy is not effective for secondary prevention of CVD.

Association of ABC (HbA1c, blood pressure, LDL-cholesterol) goal attainment with depression and health-related quality of life among adults with type 2 diabetes

“…As women age and go through menopause, they are likely to gain weight and experience hormonal changes. The dual impact of changing hormones and increased weight may make it more difficult for women to attain simultaneous goals than men of a similar age (Johannes & Bairey Merz, 2011).…”

Screening for Cardiometabolic Risk Profile in Middle Aged Premenopausal Indian women

“…10 They belong to the high risk group due to prevalence of various cardio metabolic risk factors including obesity, central adiposity, hyperglycemia and dyslipidemia. 11,12 In addition, physiological and hormonal parameters act as an additional risk factor for such disorders in women. 13 Burden of cardio metabolic risk in women are assessed from different corners of the world.…”

Systematic review of cardiovascular disease in women: Assessing the risk

“…Current data indicate that timing, dose, and regimen are important considerations for women when deciding on hormone therapy (Lokkegaard et al ., 2008). Menopause appears to result in an accelerated increase in LDL‐C and total cholesterol immediately following the final menstrual period (Johannes & Bairey Merz, 2011). Evidence is increasing that pregnancy might be considered a “stress test” for future CVD risk.…”