In her book Do it Like a Woman… and Change the World, Caroline Criado-Perez argues that there are significant differences in the way women present with cardiovascular disease (CVD) and how they respond to treatment.1 She states that all too often clinical trials recruit a disproportionate number of relatively healthy (ie, with few comorbidities) middle-aged men and the results are then assumed to be applicable to women.
Some major differences are known to exist between men and women with CVD and healthcare professionals need to be aware of these and apply this information in practice.
Cardiovascular risk factors
Premenopausal women have lower risk of CVD than men of the same age. This is thought to be partly due to the protective effects of oestrogen on blood vessels. However, postmenopausal women present a different picture, with an increase in certain cardiovascular risk factors, including a rise in blood pressure and low density lipoprotein and a decrease in high density lipoprotein. These changes are responsible for the increase in CVD in women following menopause.