Dyslipoproteinemia in women. Special considerations.

Heart disease is the number one cause of death in women, as it is in men; risk factors include high cholesterol, high triglycerides, low HDL-C, diabetes, hypertension, and cigarette smoking. Most of these factors are alterable. The lipoprotein profile of a woman undergoes many changes during her lifetime because of the effects of endogenous hormones at pregnancy, the administration of oral contraceptives, and estrogen replacement at the menopause. Endogenous estrogen reduces the risk of heart disease in women as does unopposed estrogen replacement in the menopause. Oral contraceptives, on the other hand, can increase risk depending on the dose prescribed. Careful attention to a woman's native lipid profile, as well as to the impact of administered hormones on her lipids, is important. It is the responsibility of the physician to help patients achieve and maintain the least atherogenic lipid profile possible as well as to identify and reduce other cardiovascular risk factors.