Beyond the conventional risk factors in the management of atherosclerosis in women: a call to action for careful consideration of obesity and inflammation

Conventional risk factors do not completely explain the burden of atherosclerotic cardiovascular disease (ASCVD) in women. Obesity and chronic low-grade inflammation are recognized as important contributors to atherosclerotic risk. This viewpoint explains the role of obesity-driven inflammation in the development and management of atherosclerosis in women. Abdominal obesity promotes a proinflammatory and prothrombotic environment that accelerates atherogenesis. Women with higher inflammatory biomarker levels and experience sex-specific risk-modifying stages, such as polycystic ovary syndrome, pregnancy-related conditions, and menopause, have higher risk for cardiovascular events, including atherosclerosis. We review evidence for antiobesity and anti-inflammatory therapies. Integrating obesity and inflammation into ASCVD care in women requires targeted screening, risk assessment, and sex-stratified research approaches. This viewpoint highlights the relation between obesity and atherosclerosis.