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INTRODUCTION

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Cardiovascular disease (CVD) remains the leading cause of death in women.1 Identification of risk factors is the first step toward the prevention of CVD. The 2011 Effectiveness-Based Guidelines for the Prevention of Cardiovascular Disease in Women classifies a woman's risk status as either high risk, at risk, or ideal cardiovascular health.2 The classic high-risk profile includes the presence of any of the following: clinical CVD, cerebrovascular disease, peripheral arterial disease, abdominal aortic aneurysm, end-stage or chronic kidney disease, diabetes mellitus, or a 10-year Framingham-predicted CVD risk of ≥10%.2 The at-risk profile includes having any of the following: cigarette use, systolic blood pressure (SBP) ≥120 mm Hg, diastolic blood pressure (DBP) ≥80 mm Hg, treatment for hypertension, total cholesterol ≥200 mg/dL, high-density-lipoprotein cholesterol (HDL-C) <50 mg/dL, treatment for dyslipidemia, obesity, poor diet, physical inactivity, family history of premature CVD in first-degree relative, metabolic syndrome, advanced subclinical atherosclerosis, poor exercise capacity on treadmill test and/or abnormal heart rate recovery after stopping exercise, systemic autoimmune collagen-vascular disease, history of preeclampsia, gestational diabetes, or pregnancy-induced hypertension.2 Ideal cardiovascular health includes having all of the following without treatment: total cholesterol <200 mg/dL, BP <120/80 mm Hg, fasting blood glucose <100 mg/dL, body mass index (BMI) <25 kg/m2, abstinence from tobacco, physical activity for adults >20 years with ≥150-min/wk moderate intensity or ≥75 min/wk vigorous intensity exercise2 (see Table 2-1).

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TABLE 2-1Classification of CVD Risk in Women
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The second step of the health care provider should be to acknowledge that not only are there sex-specific risk factors for CVD and coronary heart disease (CHD), but also that the same risk factors in men and women do not affect them equally and similarly. Understanding the sex differences in CVD risk may result in a more aggressive patient education and primary prevention of CHD and CVD. This chapter summarizes the CHD and CVD risk factors that are nonmodifiable, ...

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