Challenges in Cardiovascular Risk Prediction and Stratification in Women

There has been an appropriate focus, since the turn of the 21 st century, on sex- and gender-specific cardiovascular disease (CVD) as increasing evidence suggests that there are substantial differences in the risk factor profile, social and environmental factors, clinical presentation, diagnosis, and treatment of ischemic heart disease in women compared with men. As a result of increased awareness, detection, and treatment of ischemic heart disease in women, there has been significant reduction (greater than 30%) in cardiovascular mortality, and in 2013, more US men than US women died of CVD. Nevertheless, continued efforts are required as CVD remains the leading cause of cardiovascular morbidity and death of women in the Western world, and in women younger than 55 years there has been a rise in cardiovascular mortality. In this article, we review several of the contributing factors that continue to cause challenges in accurate risk prediction and risk stratification in women.