Vall d'Hebron has participated in the creation of a consensus document with experts in numerous clinical specialties to improve the diagnosis and management of cardiovascular diseases in women throughout their lives. Professionals from the Cardiology and Obstetrics and Gynaecology Services of the Vall d'Hebron University Hospital, the Cardiovascular Diseases and Maternal and Fetal Medicine groups of the Vall d'Hebron Research Institute (VHIR) and the CIBER of Cardiovascular Diseases (CIBERCV) have participated in the guide. The work, coordinated by the Spanish Society of Cardiology, has been published in the Revista Española de Cardiología. 

Cardiovascular diseases are the leading cause of mortality in women. In addition, an increase in cases of myocardial infarction in young women has been observed in recent years. "Early detection of common cardiovascular risk factors in men and women, and also those that specifically affect women in different life cycles, especially during adolescence, menopause, post-partum complications and certain gynaecological alterations, is essential to reduce cardiovascular diseases, improve survival and quality of life. This guide aims to raise awareness among health professionals of the importance of preventing cardiovascular disease in women, to highlight some of the differences between men and women, and to offer specific recommendations for prevention according to each stage of life", says Dr. Antonia Sambola, who led the consensus from the Cardiology Service and the Cardiovascular Diseases group at VHIR.  

"This is an important work because it is the result of a consensus between various specialties, including Family and Community Medicine, Obstetrics and Gynaecology, and Cardiology, and takes into account the cardiovascular health of women at different stages of life. Multidisciplinary work is essential in this field and from our centre we have always promoted this collaboration”, says Dr. Antonia Pijuan, specialist in the Integrated Adolescent and Adult Congenital Heart Disease Unit at Vall d'Hebron-Sant Pau and researcher of the Cardiovascular Diseases group at VHIR.  

From adolescence to menopause

The guide, written by sixteen experts in different specialities, emphasises the specific risks of each phase of women's lives and the possible alterations that may appear due to the role that sex hormones play in the control of metabolism and in the functioning of the cardiovascular system.  

Thus, for example, the importance of hormone replacement therapy in women with polycystic ovary syndrome or menopause is highlighted, especially when it is early. These situations, in which estrogen levels decrease, are associated with insulin resistance, obesity or hypertension, so their control is important to reduce cardiovascular risk.  

The document also includes recommendations for pregnancy and the postpartum period, when the body undergoes many metabolic changes associated with increased cardiovascular risk, especially in women who are already obese, hypertensive or diabetic. "Controlling cardiovascular risk factors during pregnancy and the months after delivery is essential for the health of the woman and the fetus. Therefore, a multidisciplinary team is needed to help detect risks early and take care of health", says Dr. María Goya, specialist in Obstetrics and Gynaecology at Vall d'Hebron Hospital and principal investigator of the Maternal and Fetal Medicine group at VHIR. 

Controlling risk factors to prevent cardiovascular complications

Finally, the professionals who participated in the guide stress the need to understand the risk factors associated with cardiovascular diseases and to approach them from a gender perspective. For this reason, it is essential to take into account the differences between men and women, such as the increase in blood pressure or blood fat levels due to the use of contraceptives or the menopause, as well as the greater risk of autoimmune diseases, breast cancer or anxiety and depression in women.  

"So far, there is still a lack of information on the most effective treatments for women, as historically the studies that have been carried out have been mostly in men. It is necessary to promote clinical trials that allow us to better understand the influence of differences in cardiovascular risk and to find more effective and safer personalised treatments than those that currently exist", the researchers conclude.