Prevention of cardiovascular disease in women: role of the obstetrician-gynecologist.

Cardiovascular disease poses a major threat to women's health. Obstetrician-gynecologists dominate the adult health care field in preventive services in the United States, and the scope of their preventive services should be broadened to encompass cardiovascular disease in women. Endogenous and exogenous risk factors jointly contribute to a woman's cardiovascular risk profile; the risk of cardiovascular disease should be viewed as a multifactorial phenomenon with a continuous gradient of response. Three important risk factors--serum cholesterol, hypertension, and cigarette smoking--are amenable to change and should become a principal focus of women's health care. Although preventive medicine lacks the glamour and immediate rewards of obstetric and gynecologic interventions, the long-term benefits to the health of women are compelling.