Heart disease in women - Gender-specific statistics and prevention strategies for a population at risk

For primary prevention of CAD, modifying risk factors for the disease has not been proven to decrease the risk in women. Use of HRT may have the best evidence for showing a reduction in the risk of CAD. However, clinical expertise suggests that reducing obesity, controlling hypertension, and improving lipid profiles may also affect a woman's CAD risk. Although the Nurses' Health Study(24) indicated that taking two to six aspirin per week reduced the incidence of CAD by 35%, prospective trials have yet to prove the benefit of prophylactic aspirin use in preventing mortality from CAD in women. Nevertheless, its use may be worth considering in the management of CAD risk. For secondary prevention, use of HRT is controversial and should be individualized to the patient. Women at high risk of CAD may benefit, but additional long-term studies are necessary. Evidence from observational studies suggests that low-dose aspirin use may benefit women as well as men with CAD or vascular disease. Although the documentation and strength of evidence on CAD in women are often weak or lacking, health complaints suggestive of CAD should be considered as seriously-or more seriously-in women as they are in men. Further studies are essential, and their results may change the attitudes and actions of women and their physicians with respect to this pervasive disease.