Do We Need a Different Approach to Assess Cardiovascular Risk in Women?

For many years, heart disease was considered by many to be a ‘man’s disease’. This opinion was held for several decades, despite statistics showing that more women died from heart disease annually than men. Women are not simply smaller biologic versions of men, nor are they a homogeneous group. The complexity of the effect of hormonal, biologic and physiologic factors on a woman’s cardiovascular risk cannot be understood by extrapolating our knowledge of heart disease in men. Several factors influence a woman’s risk for cardiovascular disease (CVD). While traditional risk factors have long been known, several risk factors unique to or predominant in women also confer an increased risk for CVD. In this review we highlight the burden of CVD in women, and describe risk factors that are female-specific or female-predominant. We also review current risk assessment models and their efficacy in estimating a woman’s risk for CVD.