Heartbeat: Ischemic heart disease risk factors in women

Cardiovascular disease is the leading cause of death in women worldwide. Despite the known sex differences in clinical presentation, management and outcomes of patients with coronary heart disease (CHD), possible differences in primary and secondary prevention have received less attention. In this issue of Heart , Zhao and colleagues1 investigated sex differences in cardiovascular risk factor management in over 10 thousand patients (29% women) from Europe, Asia and the Middle East. Compared with men, women had better blood pressure control and were more likely to be non-smokers. However, women were less likely to achieve medication targets for total cholesterol, low density lipoprotein cholesterol or serum glucose levels. In addition, women were more often obese and less physically active than men. Overall, lifestyle targets for cardiovascular risk reduction did not differ between women and men but women were about 25% less likely to achieve medication treatment targets with marked geographic sex disparities for both lifestyle and medication treatment targets (figure 1). Figure 1 Age-adjusted sex differences on treatment targets and lifestyle factors management, stratified by region. Target blood pressure (BP) was defined as BP <140/90 mmHg in those without diabetes or <140/80 mmHg in those with diabetes. The target for total cholesterol (TC), low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol levels were defined …