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Cardiology in Review: July-August 1997
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Coronary heart disease (CHD) and cardiovascular risk factors are so prevalent in the United States that estimating and reducing risks is appropriate for all women. The probability of developing CHD can be estimated from information on total and high-density lipoprotein cholesterol, blood pressure, cigarette smoking, body weight, and family history of CHD. Several methods for estimating risk in apparently healthy women are discussed in this article. Women at high risk can be identified from risk factor profiles or because they have cardiovascular diseases, diabetes, or premature menopause. Risks of CHD can be reduced in all women by not smoking, healthy diets, physical activity, and weight control. Women at high risk should be managed more aggressively with interventions appropriate to their specific risk factor profiles. Pharmacologic treatments of lipid abnormalities and high blood pressure have been proven to be effective in reducing morbidity and mortality from CHD. Hormone replacement therapy improves lipid profiles and reduces fibrinogen levels; it is associated with lower CHD incidence in observational studies. Management of prevalent disease is beyond the scope of this article. New risk and protective factors are being identified, but effective preventive and treatment options are available currently and should be selected by the physician and patient based on knowledge of risk for CHD and other diseases.

© Williams & Wilkins 1997. All Rights Reserved.