Kuller Lewis H
Department of Epidemiology, University of Pittsburgh, 130 North Bellefield Avenue, Pittsburgh, PA 15213, USA.
Expert Rev Cardiovasc Ther. 2010 Feb;8(2):175-87. doi: 10.1586/erc.09.125.
Coronary heart disease (CHD) among women is preventable. Women with minimal cardiovascular risk factors and low coronary calcium scores have a very low incidence and mortality due to CHD. Women have much less coronary atherosclerosis than men, especially those of younger age groups. The lower coronary atherosclerosis is likely a function of both lower risk factors premenopausal and the effects of estrogen on the arterial wall. Reduction of elevated risk factors, such as atherogenic lipoproteins, systolic blood pressure and smoking cessation, results in substantial reduction in the risk of CHD for both men and women. There is relatively little evidence that these effects are different for men as compared with women. The prevention of increase in risk factors premenopausal (primordial prevention) by public health initiatives, individualized lifestyle intervention and more aggressive pharmacological therapies for most postmenopausal women to prevent the development and progression of atherosclerosis and thrombosis are the cornerstone of CHD prevention for women and will have the greatest impact on women's cardiovascular health, improving quality of life, decreasing healthcare costs for CHD and substantially decreasing health disparities.
女性冠心病（CHD）是可预防的。心血管危险因素极少且冠状动脉钙化评分低的女性，因冠心病导致的发病率和死亡率非常低。女性的冠状动脉粥样硬化比男性少得多，尤其是年轻年龄组的女性。冠状动脉粥样硬化程度较低可能是绝经前危险因素较低以及雌激素对动脉壁作用的共同结果。降低升高的危险因素，如致动脉粥样硬化脂蛋白、收缩压和戒烟，可使男性和女性患冠心病的风险大幅降低。相对而言，几乎没有证据表明这些影响在男性和女性之间存在差异。通过公共卫生举措、个体化生活方式干预以及对大多数绝经后女性采用更积极的药物治疗来预防绝经前危险因素的增加（一级预防），以防止动脉粥样硬化和血栓形成的发展及进展，是女性冠心病预防的基石，将对女性心血管健康产生最大影响，改善生活质量，降低冠心病的医疗费用，并大幅减少健康差距。
