A new European Society of Cardiology (ESC) consensus document provides guidance on diagnostic approach and management of cardiovascular health of women during menopause and after pregnancy disorders or other gynecologic conditions, based on current evidence and practice. Published Jan. 25 in the European Heart Journal, the document was organized by an ESC Task Force on Gender and a multidisciplinary working group on women’s health in menopause.

Led by Task Force Chair Angela H. E. M. Maas, MD, PhD, et al., the document updates a 2007 ESC consensus paper on cardiovascular risk in perimenopausal women based on “greater understanding on the role of female-specific risk factors for cardiovascular disease.”

The document provides guidance on cardiovascular risk and management related to lifestyle in menopause; vasomotor symptoms; use of menopausal hormone therapy; premature ovarian insufficiency; pregnancy-related disorders, including recurrent pregnancy loss, preterm delivery, gestational hypertension, and pregnancy in women at increased risk for ischemic heart disease. The document also provides updates based on existing evidence and practice regarding cardiovascular disease risk and management in women with hormonal imbalances and women who have had breast cancer or have tested positive for the BRCA 1/2 mutations. 

According to the authors, the “strongest predictors” of future cardiovascular risk include hypertensive disorders of pregnancy and low birth weight. “Our current knowledge of the typical patterns of ischemic heart disease in younger and middle-aged women helps to better diagnose and treat symptomatic women within this age group,” Maas, et al., write. They note that although sex-specific risk variables are known to be associated with cardiovascular risk, the “justified weighting of these variables remains to be elucidated.”

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Diabetes and Cardiometabolic Disease, Prevention, Vascular Medicine, CHD and Pediatrics and Prevention, Hypertension

Keywords: Pregnancy, Female, Hypertension, Pregnancy-Induced, Cardiovascular Diseases, Breast Neoplasms, Premature Birth, Perimenopause, Menopause, Menopause, Premature, Myocardial Ischemia, Infant, Low Birth Weight, Mutation

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