Chapter 2: RISK FACTORS FOR CARDIOVASCULAR DISEASE

INTRODUCTION

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).