Division of Cardiovascular Medicine, University of California, Davis Medical Center, Sacramento, California 95817, USA.
Clin Cardiol. 2011 Nov;34(11):658-62. doi: 10.1002/clc.20993.
Cardiovascular disease remains the leading cause of mortality in both women and men in the industrialized nations. Coronary heart disease (CHD) accounts for the single largest share of this toll in both sexes. Although it had long been known that the number 1 cause of death in men is CHD, it was determined only relatively recently that this was also true in women. Identification of the traditional risk factors (RFs) for CHD by the Framingham Heart Study and other investigations during the last 5 decades has provided the basis of preventive cardiology. These RFs can be considered as fixed or modifiable. Numerous epidemiologic and clinical studies have demonstrated that, with few exceptions, the major RFs that increase the hazard for CHD are the same for both men and women, whether fixed (age, sex, family history) or modified (lipids, blood pressure, smoking). A number of other RFs are under investigation and await confirmation in rigorous prospective studies. Even those conditions unique to women, which can predispose patients to CHD, such as polycystic ovaries and complications of pregnancy, act through provocation of the traditional RFs. Thus, the large body of evidence that supports the similarity of RFs for CHD in men and women provides a rational foundation for similar strategies of prevention in the 2 sexes.
在工业化国家，心血管疾病仍然是男女死亡的主要原因。冠心病（CHD）在两性中都占了最大的比例。尽管长期以来人们都知道男性的头号死因是冠心病，但直到最近才确定女性也是如此。弗雷明汉心脏研究（Framingham Heart Study）和过去 50 年的其他研究确定了冠心病的传统危险因素（RFs），为预防心脏病学提供了基础。这些 RFs 可以被认为是固定的或可改变的。大量的流行病学和临床研究表明，除了少数例外，无论是固定的（年龄、性别、家族史）还是可改变的（脂质、血压、吸烟），增加冠心病危险的主要 RFs 在男性和女性中都是相同的。还有许多其他的 RFs 正在研究中，并在严格的前瞻性研究中等待确认。即使是那些女性特有的、可能使患者易患冠心病的疾病，如多囊卵巢和妊娠并发症，也是通过引发传统的 RFs 起作用的。因此，大量支持男性和女性冠心病 RFs 相似的证据为两性提供了类似的预防策略的合理基础。
