Highlights
- •There are gender differences in the prevalence and awareness of major risk factors.
- •Smoking and diabetes seem to be more harmful in women.
- •Subclinical organ damage in hypertension is more prevalent in women.
- •Heart failure with preserved ejection fraction is more common in hypertensive women.
- •Women are underrepresented in large clinical trials.
Abstract
Cardiovascular disease (CVD) is the leading cause of death in women in developed countries.
The traditional modifiable risk factors are able to explain the majority of CVD mortality.
The aim of this review is to analyze gender-specific aspects of major conventional
cardiovascular risk factors and to assess whether they have the same impact on CVD
in women.
Cigarette smoking remains the single largest preventable cause of cardiovascular morbidity
and premature death worldwide. Women smoke less than men; however, smoking seems to
be more harmful in women, particularly in oral contraceptive users.
Obesity in the general population is more prevalent in women. Visceral adiposity is
associated with insulin resistance and a higher risk of developing cardiovascular
disease.
Life expectancy in female diabetic patients is shorter than in men with diabetes;
women with diabetes are also at higher risk of developing cardiovascular events.
Changes of main lipid parameters in women are frequently associated with their hormonal
status and/or hormonal treatment.
Hypertension is highly prevalent in post-menopausal women and carries a higher risk
of developing left ventricular hypertrophy, which, together with a greater increase
in vascular and myocardial stiffness, results in a higher incidence of heart failure
with preserved ejection fraction and a higher risk of developing stroke. The risk
of abdominal aortic rupture is substantially higher in women.
In conclusion, smoking, diabetes and hypertension seem to be more harmful in women.
Therefore, the question is whether there should not be lower thresholds for initiating
drug treatment in women with diabetes and hypertension.
Keywords
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Article info
Publication history
Published online: January 18, 2019
Accepted:
January 10,
2019
Received in revised form:
December 28,
2018
Received:
December 3,
2018
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
