Women and Men: Sex Differences in Cardiovascular Risk Prevention

Abstract

Cardiovascular disease (CVD) is the leading cause of death in women, and knowledge of the clinical consequences of atherosclerosis and CVD in women has grown tremendously over the past 20 years. Research efforts have increased and many reports on various aspects of ischaemic heart disease (IHD) in women have been published highlighting sex differences in pathophysiology, presentation, and treatment of IHD. For the past three decades, dramatic declines in heart disease mortality for both men and women have been observed, especially in the > 65 years’ age group. But despite it according to the Global Burden of Disease, in 2004, CVD caused almost 32 % of deaths in women worldwide vs. 27 % in men. In Europe, 54 % of all females’ death are from CVD vs. 43 % in men. Recent evidence has emerged that recognizes new, potentially independent, CVD risk factors exclusive to women. In particular, common disorders of pregnancy, such as gestational hypertension and diabetes, as well as frequently occurring endocrine disorders in women of reproductive age are associated with accelerated development of CVD and impaired CVD free survival. With the recent availability of prospective studies comprising men and women, the equivalency of major risk factors prevalence and effects on CVD between men and women can be examined. Furthermore, female specific risk factors might be identified enabling early detection of apparently healthy women with a high lifetime risk of CVD. Therefore, we examined the available literature regarding the prevalence and effects of the traditional major risk factors for CVD in men and women.