Traditional risk factors in female sex/gender
² Cardiology Unit – Casa di Cura “Villa Verde”, Taranto, Italy
³ UO UTIC – Cardiologia, AO San Camillo Forlanini, Roma
⁴ Department of Quality-of-Life Sciences, University of Bologna-Alma Mater Studiorum, Bologna, (Italy)
⁵ Universita degli Studi di Milano, Direttore del Dipartimento di Endocrinologia, Nutrizione e Malattie Metaboliche, IRCCS MultiMedica, Italy
⁶ IRCCS San Raffaele Roma, Rome, Italy
Abstract
This article provides a comprehensive overview of traditional cardiovascular risk factors in women, emphasizing the importance of gender-specific assessment and management. Although risk factors such as hypertension, obesity, dyslipidemia, diabetes, and smoking are common to both sexes, women show distinct vulnerabilities, clinical manifestations, and responses to therapy. Epidemiological studies reveal that certain hypertensive phenotypes, such as “white coat hypertension”, are more prevalent in women, and cardiovascular complications can occur at lower blood pressure thresholds than in men. Women are also more sensitive to sodium in their diet, and lifestyle changes can have different effects on reducing blood pressure. Obesity is a major risk factor, particularly in postmenopausal women, and is associated with increased blood pressure, dyslipidemia, hyperglycemia, and a higher risk of atrial fibrillation, heart failure, and sleep apnea. Management of dyslipidemia is critical to preventing atherosclerotic disease. Female lipid metabolism is affected by hormonal status, with menopause contributing to increased LDL cholesterol and lipoprotein (a) levels, further increasing cardiovascular risk. Diabetes has different prevalence and complications in men and women. Women with diabetes are more prone to depression, gastroparesis, and increased inflammatory and platelet activity, increasing their susceptibility to atherosclerosis. Smoking, both active and passive, remains a significant cardiovascular risk factor. Women who smoke are at a higher risk of coronary heart disease, and exposure during pregnancy can lead to adverse outcomes for both the mother and the newborn. It also highlights the uncertainty about the cardiovascular safety of e-cigarettes and heated tobacco devices, recommending the complete cessation of nicotine products for optimal risk reduction. Overall, the article highlights the need for personalized prevention strategies, diagnostic pathways and therapeutic approaches that take into account gender and sex differences.
Key words: Women; Cardiovascular Risk Factors; Gender Differences; Hypertension; Obesity; Dyslipidemia; Diabetes; Smoking.
