Preventive coronary interventions for women.

In summary, coronary heart disease is an equal opportunity killer for women and thus requires the equal application of preventive interventions. Areas to be highlighted include intensive coronary risk reduction for diabetic women of all ages, because these are women at high risk. Smoking cessation has high priority both for healthy women and for women with defined coronary disease. Emphasis should also be placed on weight reduction in overweight women as a means of lessening hypertension, glucose intolerance, hyperlipidemia, and the like. Hypertension control likely imparts greater stroke than coronary benefit for women, based on available data. There is substantial evidence that moderate-intensity leisure exercise, as a means of imparting physical fitness, has widespread and powerful survival benefits. The efficacy of lipid-lowering interventions has been less extensively documented in the literature, although the extent of cholesterol lowering and resultant decline in rates of coronary heart disease were often comparable for women and men. Finally, postmenopausal hormone therapy appears a promising approach to addressing a risk attribute unique to women; however, definitive recommendations must await the result of ongoing clinical trials, both in healthy women and in women with coronary heart disease.