Cardiovascular Disease in Women Part 1: Sex and Gender Differences in Cardiovascular Conditions and Risk Factors

Cardiovascular (CV) disease affects nearly 50 million women in the United States and is the leading cause of death in this country, yet women do not always recognize the impact of CV risk on health nor are they aware of risk factors specific to women. Physicians also lack awareness of gender-specific risk factors. Traditional risk factors such as hypertension, diabetes, smoking, and obesity increase both men and women’s risk for heart disease but are often less well controlled in women. Women also have unique risk factors; eliciting a pregnancy history is critical in assessing a woman’s cardiovascular risk as parity and pregnancy complications can impact cardiovascular health. Also unique to women, breastfeeding has been shown to decrease the risk of CVD, while menopause increases CVD risk. Emerging concerns related to breast cancer treatment and autoimmune disease also confer excess cardiovascular disease risk for women. In this chapter, we discuss factors contributing to cardiovascular risk in women and an approach to estimating that risk.