Impact of Major Cardiovascular Disease Risk Factors, Particularly in Combination, on 22-Year Mortality in Women and Men

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Abstract
CARDIOVASCULAR diseases (CVDs), primarily coronary heart disease (CHD), remain leading causes of death in both men and women in the United States.1 While much of the knowledge about CVD risk factors comes from studies in men, some prospective studies have included women.2-14 Despite limitations in some studies due to inclusion of small numbers of women, few years of follow-up, or limited numbers of clinical events, findings generally indicate that major modifiable risk factors for CVD in men (high blood pressure, high blood cholesterol level, and smoking) are also important in women. Nevertheless, the relative importance of CVD risk factor status and appropriate approaches to prevention of CVD in women continue to be debated.15-17 A less intensive approach to CVD prevention in women than in men has been advocated by some,6,15,18,19 but this view and the argument for it have been challenged.16,17,20,21

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