II coure delle donne

Heart diseases in women have a very different incidence and prognosis from that of men. However, the selected diagnostic tools are very different in relation to gender. In a gender-related approach to atherosclerotic disease, one of the most important topic is the evaluation of risk to develop cardiovascular events in women. This review represents the opinion of a task force of the Italian Society of Cardiology, on all debated issues regarding the relationship between women and heart diseases. This working group has analyzed the literature published in the last years, integrating the concepts emerged from the experience of physicians accustomed to the study and treatment of women with heart diseases. First of all, we analyzed the epidemiology of coronary heart disease in women, emphasizing the differences in the risk of developing cardiovascular events between European and American women. Then, we illustrated the new risk factors for ischemic heart disease that have specifically been studied in large female populations. These new risk factors could be used for a better evaluation of the cardiovascular risk, and for analyzing gender differences in diagnosis, response to therapy and prognosis of atherosclerotic disease. Some considerations about postmenopausal hormone replacement therapy were done, by providing suggestions for a corrected diagnosis and therapeutic approach in women with known cardiovascular disease. Atherosclerosis represents a really different disease in females with respect to males. The analysis of the literature supports the hypothesis that the pathophysiological mechanisms of this disease may be different or peculiar according to gender. We therefore suggest a tailored approach to this disease, in order to better quantify global cardiovascular risk, treat and prevent cardiovascular diseases, with the aim to reduce cardiovascular mortality and morbidity.