Preventing cardiovascular disease in women: an update.

Coronary heart disease (CHD) continues to be the leading cause of death among women in the United States. Evidence-based guidelines of the American Heart Association (AHA) offer clinicians recommendations for preventing CHD in women delineating particular lifestyle, risk factor, and pharmacologic interventions. Cigarette smoking, physical inactivity, inappropriate diet, dyslipidemia, hypertension, diabetes mellitus, and metabolic syndrome contribute to the risk of CHD in women, as in men. Lifestyle interventions substantially reduce that risk. Many women, however, require pharmacotherapy to control hypertension, dyslipidemia, and diabetes to levels required for decreasing risk. New findings from clinical trials featuring women may enhance their CHD risk prediction and treatment. However, high coronary risk in many women continues to be underrecognized, and women remain undertreated with statins and other therapeutic agents.