Table 3. Risk Assessment in Women
ÎThe focus on 10-year CHD risk may substantially underestimate clinically relevant overall CVD risk and therefore tends to preclude the warranted, intensive preventive measures for most high-risk women. Several lines of evidence support the focus of women's guidelines on long-term risk for CVD rather than solely on 10-year risk for CHD. A lower score is not sufficient to ensure that an individual women is at low risk. The current guidelines recommend use of a new cut point for defining high risk as 10% 10-year risk for all CVD, not just CHD alone.
ÎPolycystic ovarian syndrome, preeclampsia, pregnancy-induced hypertension, gestational diabetes, pre-term births or small birth weights have emerged as indicators of future CVD risk. Clinicians should take a careful and detailed history of pregnancy complications.
ÎSystemic lupus erythematosus and rheumatoid arthritis are associated with a significantly increased relative risk for CVD.
ÎEven the presence of a single risk factor (listed below) at 50 years of age is associated with a substantially increased lifetime absolute risk for CHD and a shorter duration of survival.
• Cigarette smoking • Systolic BP ≥ 120 mm Hg • Diastolic BP ≥ 80 mm Hg or treated HTN • TC ≥ 200 mg/dL, HDL-C < 50 mg/dL or treated dyslipidemia • Obesity, particularly central adiposity • Poor diet • Physical inactivity • Family history of premature CVD occurring in first degree relatives: In men < 55 years of age or in women < 65 years of age
• Metabolic syndrome • Poor exercise capacity on treadmill test and/or abnormal heart rate recovery after stopping while on treatment
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