38
Management
4.2.3.4. Reproductive Risk Markers
COR LOE
Recommendation
2a B-NR
1. In adults without ASCVD, consideration of reproductive
risk markers, such as early menopause (<45 years) and
history of adverse pregnancy outcomes (gestational
hypertension, preeclampsia, gestational diabetes, preterm
delivery) is reasonable to personalize ASCVD risk
assessment when considering the potential benefit of
initiating LLT as an adjunct to lifestyle management for
primary ASCVD prevention.
Table 14. Reproductive Risk Markers Associated With
ASCVD Events
Adverse Pregnancy Outcomes* That Have a Stronger Association With ASCVD
Events
• Hypertensive disorders of pregnancy (preeclampsia, gestational hypertension)
• Gestational diabetes
• Small-for-gestational age (birthweight below the 10th percentile)
• Preterm delivery (before 37 weeks' gestation)
• Recurrent spontaneous pregnancy loss
Other Reproductive Risk Markers
• Early menarche (<10 y old)
• Early menopause (<45 y old), especially premature menopause (<40 y old)
• Polycystic ovarian syndrome and irregular menses
* See reference for a full list of Adverse Pregnancy Outcomes.
ASCVD indicates atherosclerotic cardiovascular disease; and y, years.
