Maintaining cardiovascular health: An approach specific to women.

There is an ongoing misperception that women under 60 years of age are at low risk of cardiovascular disease (CVD). As there is an important variation in risk among women in this age group, we need to tailor risk assessment by using additional risk parameters during their life-course. For this, valuable tools are family risk, female-specific risk factors and inflammatory co-morbidities, which can be enriched by measuring the coronary artery calcium (CAC) score using computerized tomography. Depending on the results, we can readily adapt lifestyle advice and preventive treatment to every individual woman. Progress has been made in the recognition of stable and unstable manifestations of ischemic heart disease in middle-aged women. Whereas the traditional cardiovascular risk factors are involved in classic obstructive coronary disease, female-specific risk variables, inflammatory co-morbidities and psychosocial stress are also involved in other types of ischemic disease. We therefore need a more sex- and gender-sensitive way to look at women's cardiovascular health.