Abstract
Coronary heart disease remains the most common cause of death among women. This review summarizes observational studies of lipoproteins and coronary heart disease risk and randomized trials of lipid-lowering therapy among women and reviews progress in the implementation of proven therapies in clinical practice. Recent studies confirm the strong relationship between lipoproteins and coronary heart disease development among women and extend these observations to more diverse populations. The apoprotein B/A-1 ratio is emerging as the strongest marker of coronary heart disease risk while enthusiasm for the importance of small dense LDL particles appears to be waning. International observational data re-affirm the importance of traditional risk factors in coronary heart disease development. Recent clinical trials suggest that intensive therapy with statins may provide incremental benefits. While there is progress in awareness, treatment and control of dyslipidemia, substantial proportions of women (and men) remain untreated or undertreated in the US and elsewhere. Dyslipidemia and coronary heart disease risk among women are closely linked. The benefits of lipid-lowering treatment are well documented, but the full potential of such therapies has yet to be realized, in part due to delayed diagnosis of dyslipidemia, underutilization of therapy by providers, and poor adherence to treatment among patients.
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