Prevention of Cardiovascular Disease in Women 2016 (2nd Edition)

Cardiovascular disease, till this day, remains the primary cause of mortality globally. Although it affects both genders, a greater emphasis appears to be placed on male patients, who appear to develop the disease at an earlier age compared to females. However, it is also known the incidence of cardiovascular disease in females rapidly rises to match males after menopause. From the National Cardiovascular Disease Registry in Malaysia (2011-2013), it was demonstrated that female patients had a higher in-hospital and 30-day mortality for acute coronary syndrome compared to male patients. Such statistics demand a greater focus being placed, not only on the diagnosis and treatment, but critically on the prevention of cardiovascular disease in women in our

Malaysia has a rising prevalence of cardiovascular risk factors in the population. Diabetes, hypertension and dyslipidaemia afflict both gender groups. Coupled with smoking and other non-communicable cardiovascular risk factors, it is important to place equal emphasis on both gender groups in the effort to prevent cardiovascular disease. The Ministry of Health is committed towards reducing the rates of non-communicable diseases, including those leading to cardiovascular disease, and these Guidelines form an important reference point to all stakeholders.

The advent of newer diagnostic and therapeutic strategies has also provided the opportunity to improve prevention of cardiovascular disease, including in women. Techniques such as multislice computed tomography of the coronary arteries and cardiac magnetic resonance imaging provide the clinician greater options for disease detection, yet each has its limitations. Contemporary strategies such as these will enhance the capacity of the clinician to improve both primary and secondary prevention of cardiovascular disease, augmenting established strategies such as the exercise stress test. Research in cardiovascular medicine has accelerated in recent years, and with such a rapidly expanding evidence base, these updated Guidelines are timely.

I am therefore grateful to the writing committee chaired by Tan Sri Dato’ Seri Robaayah, who has no doubt put countless hours into the preparation of this Clinical Practice Guidelines, which is now in its second edition. While publication becomes a useful companion for clinicians, I hope it inspires more women to the field of cardiovascular medicine.


Datuk Dr. Noor Hisham Bin Abdullah

Director-General of Health Malaysia
Ministry of Health Malaysia


Statement of intent:

This guideline was developed to be a guide for best clinical practice in the management of cardiovascular diseases in women, based on the best available evidence at the time of development. Specific attempts were made to use local data and publications to ensure local relevance. Adherence to these guidelines does not necessarilylead to the best clinical outcome in individual patient care. Every health care provider is responsible for the management of his/her unique patient based on the clinical presentation and management options available locally.

Review of the guideline:

The guideline is issued in 2016 and will be reviewed in 2021 or earlier if important new evidence becomes available. This is an update to the Clinical Practice Guidelines on Prevention of Heart Disease in Women published in 2008. This CPG supercedes the previous CPG.


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