What conditions specific to women increase the risk of ASCVD and should be considered when determining whether to prescribe a statin?
Several conditions specific to women (eg, hypertensive disorders during pregnancy, preeclampsia, gestational diabetes mellitus, delivering a preterm or low-birth-weight infant, and premature menopause (age <40 years) have been shown to increase ASCVD risk. The present guideline includes preeclampsia and premature menopause (age <40 years) as risk-enhancing factors for statin therapy because they appear to increase ASCVD risk in the same range as other risk-enhancing factors. On the other hand, the mechanism or cause of preterm birth is often unknown; therefore, it is difficult to routinely include this condition as a risk-enhancing factor for statin therapy. Furthermore, if gestational diabetes mellitus predisposes a woman to metabolic syndrome or diabetes mellitus, these are already identified as risk-enhancing or major ASCVD risk factors.