Women, lipids, and atherosclerotic cardiovascular disease: a call to action from the European Atherosclerosis Society

Abstract Cardiovascular disease is the leading cause of death in women and men globally, with most due to atherosclerotic cardiovascular disease (ASCVD). Despite progress during the last 30 years, ASCVD mortality is now increasing, with the fastest relative increase in middle-aged women. Missed or d...

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Veröffentlicht in:European heart journal 2023-10, Vol.44 (39), p.4157-4173
Hauptverfasser: Roeters van Lennep, Jeanine E, Tokgözoğlu, Lale S, Badimon, Lina, Dumanski, Sandra M, Gulati, Martha, Hess, Connie N, Holven, Kirsten B, Kavousi, Maryam, Kayıkçıoğlu, Meral, Lutgens, Esther, Michos, Erin D, Prescott, Eva, Stock, Jane K, Tybjaerg-Hansen, Anne, Wermer, Marieke J H, Benn, Marianne
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Sprache:eng
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Zusammenfassung:Abstract Cardiovascular disease is the leading cause of death in women and men globally, with most due to atherosclerotic cardiovascular disease (ASCVD). Despite progress during the last 30 years, ASCVD mortality is now increasing, with the fastest relative increase in middle-aged women. Missed or delayed diagnosis and undertreatment do not fully explain this burden of disease. Sex-specific factors, such as hypertensive disorders of pregnancy, premature menopause (especially primary ovarian insufficiency), and polycystic ovary syndrome are also relevant, with good evidence that these are associated with greater cardiovascular risk. This position statement from the European Atherosclerosis Society focuses on these factors, as well as sex-specific effects on lipids, including lipoprotein(a), over the life course in women which impact ASCVD risk. Women are also disproportionately impacted (in relative terms) by diabetes, chronic kidney disease, and auto-immune inflammatory disease. All these effects are compounded by sociocultural components related to gender. This panel stresses the need to identify and treat modifiable cardiovascular risk factors earlier in women, especially for those at risk due to sex-specific conditions, to reduce the unacceptably high burden of ASCVD in women. Graphical Abstract Graphical Abstract Key messages from this EAS position statement. In addition to sex-specific risk factors, women are disproportionately impacted by some lifestyle factors which increase cardiometabolic risk, and atherosclerotic cardiovascular disease presentation differs from that in men. Action is needed to change the perception of risk, assess and treat elevated risk factors early, and address gaps in the management and understanding of cardiovascular risk in women. CAD, coronary artery disease; CV, cardiovascular; FH, familial hypercholesterolaemia; Lp(a), lipoprotein(a).
ISSN:0195-668X
1522-9645
DOI:10.1093/eurheartj/ehad472