Premenopausal risk factors for coronary artery disease

Abstract

The premenopausal period is a time when the risk of coronary events for women is low. It is, however, a key period during which the atherosclerotic process, the leading cause of death in women, becomes established. The role of female sex hormones in protecting premenopausal women from overt atherosclerosis is widely accepted. Proof of a direct oestrogen, atheroprotective effect, however, continues to prove elusive. The specific risk factors are diabetes, hypertension, lipid abnormalities, smoking, body habitus, inflammatory disease and prothrombotic tendencies. Reproductive factors do not appear to play a major role in defining cardiac risk and the absolute risk posed by the oral contraceptive is low; concerns about cardiac risk should not be exaggerated.