The Top Five Women’s Health Issues in Preventive Cardiology

Purpose of Review This review elucidates gender-based determinants of cardiovascular disease in an effort to answer common questions that arise for practitioners as they provide preventive care to women. Recent Findings Five key topics are at the forefront of recent and ongoing research: (1) coronary microvascular dysfunction, (2) hormone replacement therapy, (3) breast arterial calcification, (4) calcium and vitamin D supplementation, and (5) metabolic considerations during pregnancy. Summary Microvascular dysfunction is a common cause of angina in women, and should be treated with the same rigor as macrovascular coronary disease. Hormone replacement therapy is not universally cardioprotective and is safer when started closer to onset of menopause. Breast arterial calcifications should be considered as a significant cardiovascular risk factor. Supplementation with calcium in excess of physiologic levels might be harmful, and vitamin D has not been proven as an effective preventive strategy. Finally, metabolic disorders seen during pregnancy have long-lasting implications for the development of cardiovascular disease.