Prevention of cardiovascular disease in women

Appropriate screening and lifestyle modification are the foundations of effective cardiovascular disease (CVD) prevention in women. All adult women should undergo a cardiovascular risk assessment, including family history, smoking, diet, and exercise assessments, and measurement of fasting lipid profile, waist and hip dimensions, and blood pressure. Women should be advised of their 10-year estimated risk of developing a cardiovascular event using the Framingham risk calculator as recommended by the National Cholesterol Education Program. Based on the level of risk, women should receive counseling on dietary modification, physical activity, weight loss, and the need for pharmacologic intervention for blood pressure, lipid, and diabetes management. In addition, women who are overweight, have a history of gestational diabetes, or family history of diabetes should have a fasting glucose measured. Women who smoke should receive advice, encouragement, and assistance for smoking cessation. Postmenopausal hormone therapy should not be considered a treatment option for primary or secondary prevention of CVD. Women and their families should be advised of the possible signs of CVD and the need to seek immediate medical attention in the event of prolonged, new, or severe symptoms. Women with coronary artery disease especially need close attention to their risk factor levels and should receive intensive intervention to achieve optimal control.