Do we have new preventive strategies for optimizing cardiovascular health in women?

Abstract

Over the past decades, progress in efforts to reduce cardiovascular morbidity and mortality has been achieved, although a disturbing trend for stagnation of cardiovascular mortality rates among younger women compared with those in younger men has been identified. While the menopause transition has traditionally offered an unequivocal opportunity to assess cardiovascular risk and counsel women to adopt preventive strategies, the veritable ‘window of opportunity’, usually applied to the concept of timing the initiation of menopausal hormone therapy, must be opened much wider to encompass younger women including those who have experienced adverse events during pregnancy, treatment for breast cancer, and premature menopause. Collaborative efforts by a number of expert medical groups provide encouragement and justification for an aggressive approach to identify and modify cardiovascular risk earlier in younger women, starting at age 20 years. Quantifying cardiovascular risk with country and population-specific risk calculators can be helpful to validate perception of risk and encourage preventive recommendations. Adherence to established guidelines for lifestyle measures (smoking cessation, healthful eating habits, enhanced physical activity, and weight control) along with treatment of traditional risk factors – hypertension, glucose intolerance, and dyslipidemia – provides a sound basis for prevention of cardiovascular disease in women.

摘要

在过去几十年中, 降低心血管疾病发病率和死亡率的努力都取得了进展, 尽管已经确认年轻女性与年轻男性相比心血管疾病死亡率持平这令人不安的趋势。尽管绝经过渡期传统上提供了评估心血管疾病风险的明确机会, 并建议女性采取预防策略, 但真正的“机会之窗”, 通常适用于绝经激素治疗开始时机的概念, 必须更广泛地开放以包括那些在妊娠期经历过不良事件, 治疗乳腺癌和早绝经的年轻女性。许多专家医疗团体的共同努力为年轻女性从20岁开始早期识别和改变心血管疾病风险的积极方法提供了鼓励和理由。使用国家和特定人群风险计算器量化心血管疾病风险有助于证实风险认知并鼓励预防性建议。坚持生活方式的既定指导方针（戒烟, 健康饮食习惯, 增强身体活动和控制体重）以及治疗传统危险因素-高血压、糖耐量异常和血脂异常-为预防女性心血管疾病提供了坚实的基础。

Keywords:

• Heart disease prevention
• risk assessment
• adverse pregnancy outcomes
• breast cancer
• menopause

Conflict of interest

No potential conflict of interest was reported by the author.

Additional information

Funding

Nil.