Cardiovascular Disease in Women

Atherosclerotic cardiovascular disease (ASCVD) is estimated to affect more than 8.5 million women in the USA. Sex-specific differences in the risk factors, natural history, diagnosis, and treatment of cardiovascular disease have been increasingly recognized over the past 30 years. The impact of traditional risk factors (including hypertension, diabetes, obesity, and tobacco use), risk markers (including CRP), and risk-enhancing factors (including premature family history of ASCVD, adverse pregnancy outcomes, and inflammatory biomarkers) modify the risk of cardiovascular disease. In recent years, growing attention has been paid to menstrual and obstetric histories when addressing cardiovascular risk in women, subsequent screening, and risk-modifying therapies. Risk of ASCVD should also be considered in the discussion of hormone therapy in peri- and post-menopausal women. Sex-specific differences in modifiable and non-modifiable risk factors must be incorporated into routine clinical decision making in the primary care setting to reduce disparities in the diagnosis and management of cardiovascular disease.