Med. praxi. 2014;11(5):207-209

Vascular disease in women before menopause

MUDr.Jan Piťha, CSc.

Laboratoř pro výzkum aterosklerózy, Centrum experimentální medicíny, IKEM, Praha

Atherosclerotic disease affects women to similar extent as men. Nevertheless, in women atherosclerosis develops and progresses later

in life. Regarding atherosclerotic changes and cardiovascular risk factors, women are more susceptible to smoking, diabetes mellitus and

dyslipidemia, the latter mainly represented by remnant lipoproteins; mechanisms of this increased sensitivity are not yet known. The

main reason for the differences between men and women could be female sex hormones, namely estrogens. After menopause the level

of estrogen significantly decreases and leads to an increased cardiovascular risk. However, hormone replacement therapy exerted no protective

effect to menopausal women. Therefore, recently the main approach is focused on management of traditional cardiovascular risk

factors, especially smoking, diabetes mellitus, and elevated triglycerides and optimally it should precede menopause. Similarly as in men

in women the drug of choice to correct dyslipidemias are 3-hydroxy 3-methylglutaryl coenzyme A reductase inhibitors (statins), lowering

mainly LDL cholesterol, especially in the population of women with already present cardiovascular disease of atherosclerotic origin. Despite

menopause is considered as a time of acceleration of atheroslerotic changes, the latter could begin yet before reaching this point.

Keywords: women, cardiovascular disease, atherosclerosis, risk factors, gender differences

Published: September 10, 2014  Show citation