Practical proposal for stratification and cardiovascular prevention in women
² Unita Operativa di Cardiologia, Ospedale S. Maria del Carmine, Rovereto (Trento), APSS, Italy
Abstract
This section presents a practical proposal for cardiovascular risk stratification and prevention in women, integrating the latest recommendations from the European Society of Cardiology (ESC) and recent scientific evidence. Traditional risk assessment tools, such as SCORE2 and SCORE2-OP, are recommended for estimating 10-year cardiovascular risk but may underestimate risk in women, especially younger individuals, due to the exclusion of sex- and gender-specific factors. The chapter emphasizes the importance of incorporating additional risk modifiers, including reproductive history, pregnancy complications (such as gestational hypertension, preeclampsia, and gestational diabetes), early menopause, and psychosocial determinants, into clinical decision-making to achieve a more accurate risk profile. The document also addresses the unique challenges of risk assessment in transgender populations, recommending the use of ESC risk scores based on sex assigned at birth and the integration of factors related to gender-affirming therapies. The document provides a practical flowchart and checklist to guide clinicians in systematic risk evaluation and management, aiming to reduce the underestimation of cardiovascular risk in women.
Key words: Women; Transgender Persons; Cardiovascular Risk Stratification; Risk Modifiers; Prevention; Multidisciplinary Approach; Personalized Medicine.
