Promoting Cardiovascular Health in Midlife Women

Abstract

Cardiovascular disease (CVD) remains the number one cause of death in the USA. In women, coronary heart disease (CHD) accounts for 22% of deaths with an additional 6.2% of deaths secondary to stroke. The prevalence of CVD increases as women age; after the age of 75, the incidence will exceed that reported for men. The risk for CVD in women is systematically underestimated. Both healthcare providers and women need a better understanding of the mechanism and role of traditional CVD risk factors (CVDRF) in women, and the newer identified non-traditional CVDRF which are unique to women and the resulting CVD morbidity and mortality. Women with a CVD event often do not present the same as men. During middle-age and the transition to post-menopause, the complaints women experience often do not match the standard male-oriented CVD symptoms, and thus are often erroneously attributed to menopause. Unique sex-gene expression and function account for the biological variances in both CVDRF and CVD prevalence and presentation in women. There is a need for a more sex-specific approach to CVDRF assessment and targeted reduction in women. There are major differences in the risk, development, and presentation of CVD in women. A wide-spread awareness is lacking in women and healthcare providers of the unique sex-specific differences in both CVDRF and CVD in women. The traditional CVD risk factor assessment tools and CVD risk calculators do not account for these differences and systematically underestimate CVD risk in women.