Cardiovascular risk assessment: more sex please

This editorial refers to ‘Underrepresentation of sex in reporting traditional and emerging biomarkers for primary prevention of cardiovascular disease: a systematic review’, by A. Gohar et al., on page 99. Treatment of individuals at higher risk of cardiovascular events with primary prevention medication has been an important part of coronary care for over 20 years. During this time, substantial gains have been made in reducing mortality from coronary heart disease (CHD),1 in part due to use of primary prevention medications such as statins.2 Yet, at all ages, these gains in mortality reduction have not been shared equally between men and women.3,4 While the causes of these age and sex differences in mortality reductions are not well understood, it is recognized that cardiovascular risk estimates by primary care physicians are often imprecise, contributing to suboptimal preventive treatment in real-world clinical practice.5 There is a need for more accurate sex-specific risk assessment, based on better understanding of sex differences in the way circulating biomarkers affect cardiovascular outcomes, to drive further reductions in cardiovascular disease (CVD) mortality. Dr Gohar and colleagues have undertaken a substantial systematic review of the evidence for sex differences in baseline levels … [↵][1]*Corresponding author. Tel: +44 20 3549 5327. Email: j.george{at}ucl.ac.uk [1]: #xref-corresp-1-1