Cardiovascular disease (CVD) is the leading cause of death, responsible for over 800.000 death/year in the US.
The major Risk Factors for CVD and Coronary Artery Disease (CAD) are similar for both men and women, with several additional risk factors for women associated with pregnancy and polycystic ovaries:
| Major Coronary Heart Disease (CHD) Risk Factors | ||
| Risks you cannot control | Risks you can control | Risks unique to women |
| Age | Hypertension (HTN) | Pregnancy-related HTN |
| Sex | Diet | Pregnancy-related diabetes |
| Family history | A high cholesterol | Polycystic ovaries |
| Ethnicity | Diabetes | |
| Other illnesses | Smoking | |
| Obesity | ||
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| Physical inactivity | ||
| Alcohol abuse | ||
“Evolving science suggests that the overwhelming majority of recommendations to prevent CVD are similar for women and men, with few exceptions.” (Mosca, in Evidence-Based Guidelines for the Prevention of Cardiovascular Disease in Women-2011 Update.)
The INTERHEART study included approximately 30 000 men and women in 52 countries. The results demonstrated that abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, diet, and physical activity accounted for 90% of the risk of a first myocardial infarction (MI) in men and 94% in women. The risks in men and women were similar for smoking and high cholesterol; however, there was an increased risk associated with hypertension and diabetes in women.
Pregnancy-Related Factors
Hypertension
The frequency of hypertension during pregnancy is about 5%, but may include both pre-existing and pregnancy-induced high blood pressure. However, gestational high blood pressure may be associated with the development of hypertension later on in life.
Diabetes
Gestational diabetes occurs in 1% to 14% of pregnancies. The risk for developing subsequent type 2 diabetes was over 9-fold in women with gestational diabetes and increased the risk of subsequently developing CHD.
Polycystic Ovary Syndrome
About 20% of young women have polycystic ovaries, which can produce a number of cardiac riskss, including obesity, metabolic syndrome, type 2 diabetes, and high cholesterol.
References
1. Centers for Disease Control and Prevention/National Center for Health Statistics. Leading cause of death 1900–1998.
2. Mosca L, Benjamin EJ, Berra K, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women—2011 update: a guideline from the American Heart Association. J Am Coll Cardiol. 2011;57:1404–1423.
3. Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364:937–952.