Abstract
Cardiovascular disease (CVD) is a leading cause of death in women and is responsible for more deaths among women than men. Although traditional risk factors are similar between the two sexes, some factors are specific to women. There are also gender differences in CVD presentation, clinical characteristics and outcome. The poor outcome in women may be due to lack of understanding of CVD epidemiology, and gender-related differences in pathophysiology, presentation and efficacy of therapeutic interventions. Although female reproductive events including pregnancy complications such as pre-eclampsia and gestational diabetes may indicate cardiovascular risk, few women have access to long-term follow up and advice about life style modification to reduce these risks. Furthermore, current cardiovascular risk stratification strategies do not include pregnancy-related risk factors such as pre-eclampsia. Primary prevention to reduce the burden of CVD in women would depend on more robust risk stratification methods that incorporate reproductive history, particularly pregnancy-related complications. This review addresses gender-specific cardiovascular risk factors that may be present during intrauterine development, adolescence, reproductive years and the menopause. It also highlights the effects of pregnancy complications on long-term female cardiovascular risk.
Keywords: cardiovascular disease, cardiovascular risk, pre-eclampsia, hypertension, pregnancy