Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, Guangzhou, China.
J Am Coll Cardiol. 2024 Jun 25;83(25):2690-2707. doi: 10.1016/j.jacc.2024.04.028.
Cardiovascular diseases (CVDs) are responsible for approximately 35% of all deaths in women. In 2019, the global age-standardized CVD prevalence and mortality of women were 6,403 per 100,000 and 204 per 100,000, respectively. Although the age- and population-adjusted prevalence has decreased globally, opposite trends are evident in regions of socioeconomic deprivation. Cardiovascular health and outcomes are influenced by regional socioeconomic, environmental, and community factors, in addition to health care system and individual factors. Cardiovascular care in women is commonly plagued by delayed diagnoses, undertreatment, and knowledge gaps, particularly in women-specific or women-predominant conditions. In this paper, we describe the global epidemiology of CVD and highlight multilevel determinants of cardiometabolic health. We review knowledge and health care gaps that serve as barriers to improving CVD outcomes in women. Finally, we present national, community, health care system, and research strategies to comprehensively address cardiometabolic risk and improve outcomes in women.
心血管疾病（CVDs）导致的死亡约占女性总死亡人数的 35%。2019 年，全球女性心血管疾病的标化患病率和死亡率分别为每 10 万人 6403 例和 204 例。尽管全球年龄和人口调整后的患病率有所下降，但在社会经济贫困地区却呈现出相反的趋势。心血管健康和结局除了受医疗保健系统和个体因素影响外，还受到区域社会经济、环境和社区因素的影响。女性心血管疾病的诊治通常存在延迟、治疗不足和知识差距等问题，尤其是在女性特有的或以女性为主的疾病中。本文描述了 CVD 的全球流行病学，并强调了影响心血管代谢健康的多层次决定因素。我们回顾了知识和医疗保健差距，这些差距是改善女性 CVD 结局的障碍。最后，我们提出了国家、社区、医疗保健系统和研究策略，以全面解决心血管代谢风险并改善女性的结局。
