Women, lipids, and atherosclerotic cardiovascular disease:a call to action from the European Atherosclerosis Society

Cardiovascular disease is the leading cause of death in women and men globally, with most due to atherosclerotic cardiovascular disease (ASCVD). Despite progress during the last 30 years, ASCVD mortality is now increasing, with the fastest relative increase in middle-aged women. Missed or delayed diagnosis and undertreatment do not fully explain this burden of disease. Sex-specific factors, such as hypertensive disorders of pregnancy, premature menopause (especially primary ovarian insufficiency), and polycystic ovary syndrome are also relevant, with good evidence that these are associated with greater cardiovascular risk. This position statement from the European Atherosclerosis Society focuses on these factors, as well as sex-specific effects on lipids, including lipoprotein(a), over the life course in women which impact ASCVD risk. Women are also disproportionately impacted (in relative terms) by diabetes, chronic kidney disease, and auto-immune inflammatory disease. All these effects are compounded by sociocultural components related to gender. This panel stresses the need to identify and treat modifiable cardiovascular risk factors earlier in women, especially for those at risk due to sex-specific conditions, to reduce the unacceptably high burden of ASCVD in women

A diagnostic algorithm for the atherogenic apolipoprotein B dyslipoproteinemias.

Item does not contain fulltextGiven the high prevalence of the atherogenic forms of apolipoprotein B (apoB) dyslipoproteinemias and the effectiveness of appropriate therapy, we feel that access for all physicians to simple, effective diagnostic aids that enable use of widely available technology is vitally important in clinical lipidology. In this Review, therefore, we present a diagnostic algorithm for the diagnosis of these disorders that is based on concentrations of total cholesterol, triglyceride and apoB. By including apoB values, lipoprotein number and composition can be deduced and each of the classic dyslipoproteinemias identified. All three parameters can be accurately and inexpensively determined in clinical laboratories and, therefore, this algorithm can be used by any physician to make an accurate diagnosis without use of specialist research laboratories. Just as the application of LDL cholesterol measurement moved clinical practice forward from plasma lipids to lipoprotein lipids, we believe that the use of apoB will further advance diagnosis and treatment of dyslipoproteinemias