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Table 1: Desirable target goals for cardiovascular risk factors in women. |
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CVRF |
Goal |
Considerations in women |
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Hypertension |
Optimal: < 120/80 mmHg Normal: 120-129/80-84 mmHg High normal: 130-139/85-89 mmHg Grade 1 hypertension: 140-159/90-99 mmHg |
Rule out secondaries in young people of childbearing age: renal parenchymal disease renovascular (muscular fibrodysplasia), hyperaldosteronism, hypothyroidism, oral contraceptives, illicit drugs, herbal products, pheochromocytoma, coarctation of the aorta, Turner syndrome, Takayasu’s arteritis, systemic lupus erythematosus, rheumatic diseases, preeclampsia predisposes to the development of hypertension in the long term. Higher prevalence in postmenopausal women More isolated systolic hypertension More white coat hypertension More left ventricular hypertrophy More adverse effects with some antihypertensives Different drug bioavailability |
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Dyslipidemia |
Primary objective LDL- Very high risk < 55 mg/dL High risk < 70 mg/dL Moderate risk < 100 mg/dL Low risk < 115 mg/dL Secondary objective is non-HDL-C+ Very high risk < 85 mg/dL High risk < 100 mg/dL Moderate risk < 130 mg/dL Low risk not established + non-HDL cholesterol, can be the primary target when the triglyceride level is > 400 mg/dL Serum triglycerides are not a control target |
Determination of the lipid profile, particularly in menopause, due to the increased cardiovascular risk Integrate the determination of the thyroid profile (the most frequent cause of secondary dyslipidemia) The scope of goals is lower in women, and also the prescription of lipid-lowering therapies Female gender is a possible risk factor for more side effects Hypolipidemic therapy is not recommended during pregnancy and lactation |
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Diabetes mellitus |
ADA HgA1c < 7% ASA DM who are at increased risk of CVD CAC/AHA HgA1c < 7% ASA There are no specific recommendations for DM CES HgA1c < 7% and < 6.5%, if it can be achieved without hypoglycemia (less stringent in elderly patients) ASA only in very high risk/high risk |
Increased CVD risk in women and increased risk of CVD mortality Screening for CV risk 3 months after delivery. Vigilance: in weight changes every 6 to 12 months. Girls have higher rates of DM In youth: increased insulin resistance early childhood to puberty; increases incidence of congestive heart failure and mortality
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