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Cardiovascular Disease Prevention
in Women: Current Guidelines

  • A five-step approach
    •                 Assess and stratify women into high risk, at risk,
      and optimal risk categories
    •                 Lifestyle approaches recommended for all women
    •                 Other cardiovascular disease interventions:
      treatment of HTN, DM, lipid abnormalities
    •                 Highest priority is for interventions in high risk patients
    •                 Avoid initiating therapies that have been shown
      to lack benefit, or where risks outweigh benefits
    • High Risk
    • Diabetes mellitus
    • Documented atherosclerotic disease
    • Established coronary heart disease
    • Peripheral arterial disease
    • Cerebrovascular disease
    • Abdominal aortic aneurysm
    • Includes many patients with chronic kidney disease, especially
      ESRD 10-year Framingham global risk > 20%, or high risk based
      on another population-adapted global risk assessment tool
    • At Risk:
    • > 1 major risk factors for CVD, including:
    • Cigarette smoking
    • Hypertension
    • Dyslipidemia
    • Family history of premature CVD (CVD at < 55 years
      in a male relative, or < 65 years in a female relative)
    • Obesity, especially central obesity
    • Physical inactivity
    • Poor diet
    • Metabolic syndrome
    • Evidence of subclinical coronary artery disease (eg coronary calcification), or poor exercise capacity on treadmill test
      or abnormal heart rate recovery after stopping exercise
    • Conclusions
    • Gender differences exist in diagnosis, treatment, and prognosis of CHD
    • Knowledge of gender differences is essential
      for appropriate therapy
    • Evidence-based guidelines provide a framework for prevention and treatment
      of cardiovascular disease in women
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