Lee Suegene K, Khambhati Jay, Varghese Tina, Stahl Eric P, Kumar Sonali, Sandesara Pratik B, Wenger Nanette K, Sperling Laurence S
Division of Cardiology, Department of Medicine, Emory University School of Medicine, Georgia.
Clin Cardiol. 2017 Oct;40(10):832-838. doi: 10.1002/clc.22767. Epub 2017 Aug 28.
Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of mortality in women. Historically, medical research has focused on male patients, and subsequently, there has been decreased awareness of the burden of ASCVD in females until recent years. The biological differences between sexes and differences in societal expectations defined by gender roles contribute to gender differences in ASCVD risk factors. With these differing risk profiles, risk assessment, risk stratification, and primary preventive measures of ASCVD are different in women and men. In this review article, clinicians will understand the risk factors unique to women, such as preeclampsia, gestational diabetes, and those that disproportionately affect them such as autoimmune disorders. With these conditions in mind, the approach to ASCVD risk assessment and stratification in women will be discussed. Furthermore, the literature behind the effects of primary preventive measures in women, including lifestyle modifications, aspirin, statins, and anticoagulation, will be reviewed. The aim of this review article was to ultimately improve ASCVD primary prevention by reducing gender disparities through education of physicians.
动脉粥样硬化性心血管疾病（ASCVD）仍然是女性死亡的主要原因。从历史上看，医学研究一直侧重于男性患者，因此，直到近年来，人们才开始逐渐意识到女性ASCVD的负担。性别之间的生物学差异以及由性别角色定义的社会期望差异导致了ASCVD危险因素的性别差异。由于存在这些不同的风险特征，ASCVD的风险评估、风险分层和一级预防措施在女性和男性中有所不同。在这篇综述文章中，临床医生将了解女性特有的风险因素，如先兆子痫、妊娠期糖尿病，以及那些对她们影响较大的因素，如自身免疫性疾病。考虑到这些情况，将讨论女性ASCVD风险评估和分层的方法。此外，还将回顾包括生活方式改变、阿司匹林、他汀类药物和抗凝在内的女性一级预防措施效果的相关文献。这篇综述文章的目的是通过对医生进行教育来减少性别差异，最终改善ASCVD的一级预防。
