National Heart and Lung Institute, Imperial College London and Royal Brompton Hospital, London, United Kingdom.
Radboud University Medical Center, Department Cardiology, Nijmegen, the Netherlands.
Mayo Clin Proc. 2020 Mar;95(3):541-553. doi: 10.1016/j.mayocp.2019.07.001. Epub 2020 Jan 22.
Cardiovascular disease is the leading cause of morbidity and mortality in women. We suggest the need to develop a paradigm that connects sex- and age-specific nontraditional risk factors that serve as a common mechanism ultimately leading to an increased risk of cardiovascular events. Vascular injury with abnormal repair leading to functional, rather than structural, abnormalities can be regarded as accelerated vascular aging. It emerges as a common feature that can trigger the early diagnosis and risk stratification for cardiovascular disease in women. We discuss sex-specific risk factors that can contribute to vascular injury with age, and these might not always be considered by cardiovascular physicians. It is important for the primary physician to be aware of these risk factors to enable more intensified management of this at-risk population. Novel technologies that allow the assessment of vascular function noninvasively can serve as key diagnostic and therapeutic tools with which we can identify such individuals and target therapy to manage this important patient population appropriately and effectively. We hope that this article will stimulate interest in this field and encourage further research in these important areas.
心血管疾病是女性发病率和死亡率的主要原因。我们建议需要建立一种模式，将性别和年龄特异性的非传统危险因素联系起来，这些危险因素作为最终导致心血管事件风险增加的共同机制。血管损伤伴异常修复导致功能而非结构异常，可以被视为加速的血管老化。它作为一个共同的特征出现，可以触发女性心血管疾病的早期诊断和风险分层。我们讨论了一些特定于性别的危险因素，这些危险因素可能会随着年龄的增长而导致血管损伤，而这些危险因素并不总是被心血管医生所考虑。初级保健医生意识到这些危险因素非常重要，这样才能对高危人群进行更强化的管理。新型的无创性血管功能评估技术可以作为关键的诊断和治疗工具，我们可以用这些工具来识别这些个体，并将治疗靶向于这些重要的患者群体，从而进行适当和有效的治疗。我们希望这篇文章能激发人们对这一领域的兴趣，并鼓励在这些重要领域进行进一步的研究。
