Female cardiovascular risk

Environmental, clinical and hormonal prevention

Abstract

Background: Cardiovascular disease (CVD) remains the leading cause of death among women worldwide, influenced by hormonal transitions, clinical determinants, and emerging environmental exposures. Persistent gender disparities in diagnosis and management further amplify this burden (1,3). Objective: To synthesize current evidence on clinical, hormonal, and environmental factors that shape cardiovascular risk in women and to propose comprehensive, gender-sensitive prevention strategies. Methods: A narrative review was conducted using PubMed, Scopus, and SciELO for studies published between January 2019 and May 2024. Original research, systematic reviews, clinical guidelines, and consensus editorials addressing female populations were included. Search terms comprised “cardiovascular disease in women”, “environmental pollution”, “endothelial dysfunction”, “menopause and CVD”, and “microplastics cardiovascular risk”. Data were analyzed qualitatively and organized into clinical, hormonal, and environmental dimensions (1,4,7). Results: Clinical factors (stress, socioeconomic inequities, and sex-specific physiology), hormonal influences (decline in estrogen and adverse pregnancy outcomes), and environmental exposures (air pollution, chronic noise, light pollution, and microplastics) synergistically heighten cardiovascular vulnerability in women. Endothelial dysfunction was identified as a central mechanism connecting these pathways (5,7). Conclusions: Reducing CVD burden in women requires integrative prevention models that address hormonal transitions, environmental exposures, and social determinants through gender-responsive health policies and personalized clinical care (1,3,6).