Is the impact of conventional risk factors the same in men and women? Plea for a more gender-specific approach
Is the impact of conventional risk factors the same in men and women? Plea for a more gender-specific approach
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DOI：
10.1016/j.ijcard.2019.01.039
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发表时间：
2019-07-01
影响因子：
3.5
通讯作者：
Kralikova, Eva
中科院分区：
文献类型：
--
作者：
Cifkova, Renata;Pitha, Jan;Kralikova, Eva
心血管疾病(CVD)是发达国家妇女死亡的主要原因。传统的可改变的危险因素能够解释大部分的心血管疾病死亡率。这篇综述的目的是分析主要传统心血管危险因素的性别方面，并评估它们是否对女性心血管疾病有同样的影响。吸烟仍然是全球心血管发病率和过早死亡的最大可预防原因。女性吸烟比男性少；然而，吸烟对女性的危害似乎更大，特别是在口服避孕药使用者中。一般人群中肥胖在女性中更普遍。内脏肥胖症与胰岛素抵抗和更高的心血管疾病风险有关。女性糖尿病患者的预期寿命比男性糖尿病患者短；女性糖尿病患者发生心血管事件的风险也更高。女性主要血脂参数的变化经常与她们的激素状况和/或激素治疗有关。高血压在绝经后女性中非常普遍，并具有更高的左心室肥厚风险，再加上血管和心肌僵硬程度的增加，导致心力衰竭的发生率更高，射血分数保持不变，发生中风的风险更高。女性腹主动脉破裂的风险要高得多。总而言之，吸烟、糖尿病和高血压似乎对女性的危害更大。因此，问题是，是否不应该降低糖尿病和高血压女性开始药物治疗的门槛。(C)2019爱思唯尔B.V.保留所有权利。
Cardiovascular disease (CVD) is the leading cause of death in women in developed countries. The traditional modifiable risk factors are able to explain the majority of CVD mortality. The aim of this review is to analyze gender-specific aspects of major conventional cardiovascular risk factors and to assess whether they have the same impact on CVD in women.Cigarette smoking remains the single largest preventable cause of cardiovascular morbidity and premature death worldwide. Women smoke less than men; however, smoking seems to be more harmful in women, particularly in oral contraceptive users.Obesity in the general population is more prevalent in women. Visceral adiposity is associated with insulin resistance and a higher risk of developing cardiovascular disease.Life expectancy in female diabetic patients is shorter than in men with diabetes; women with diabetes are also at higher risk of developing cardiovascular events.Changes of main lipid parameters in women are frequently associated with their hormonal status and/or hormonal treatment.Hypertension is highly prevalent in post-menopausal women and carries a higher risk of developing left ventricular hypertrophy, which, together with a greater increase in vascular and myocardial stiffness, results in a higher incidence of heart failure with preserved ejection fraction and a higher risk of developing stroke. The risk of abdominal aortic rupture is substantially higher in women.In conclusion, smoking, diabetes and hypertension seem to be more harmful in women. Therefore, the question is whether there should not be lower thresholds for initiating drug treatment in women with diabetes and hypertension. (C) 2019 Elsevier B.V. All rights reserved.