- Cardiovascular disease remains the leading cause of death in women,1 but mechanisms of sex-related differences that affect many facets of cardiovascular disease remain underrecognized and poorly understood. Men historically have been disproportionately represented in clinical studies, and consequently, guidelines have been built on data that are predominantly applicable to men.1 There has recently been an increasing commitment to better understand sex-related differences that affect the epidemiology, presentation, diagnosis, treatment, and outcomes of cardiovascular disease.
- Regular exercise is important to maintain health and reduce the risk of chronic disease in the general population. The greatest health benefits occur in sedentary individuals who incorporate small amounts of activity into their daily routine. Additional benefits of exercise for pregnant women include reduced rates of maternal and fetal complications, such as pre-eclampsia, gestational hypertension, gestational diabetes, Caesarean section, excessive gestational weight gain, and macrosomia.1 The trial of supervised moderate to vigorous prenatal exercise by Mireia Pelaez and colleagues,2 published in this issue of Mayo Clinic Proceedings, adds to this body of evidence.
- Barriers to care fall into 2 general categories: knowledge gaps and implementation gaps.1 The art of medicine rests on the practitioner understanding what is and is not known, recognizing the limitations of our evidence and interventions, and then developing an informed and affordable therapeutic approach that a specific patient is able and willing to follow. Given that physicians are treating patients and not conditions per se and that the patient’s condition occurs in the context of multiple other medical and sociocultural modifiers, it takes experience to become an artful physician who can walk from generalization (fund of knowledge) to individualization (application of the fund of knowledge).
- Marking an initiative by a signal date, motif, or event underscores its importance and often promotes its success. For example, in its 2004 initiative to promote awareness of cardiovascular disease as a major cause of mortality in women, the American Heart Association chose the first Friday in February of each year for an annual campaign against this disease in women and selected a red dress as the campaign's motif.1 “Go Red for Women” proved remarkably successful in engendering awareness regarding this leading cause of mortality in women and in stimulating and supporting research in this disease.
- Pregnancy is a physiologic state characterized by dynamic vascular and metabolic changes that are required for adequate uteroplacental circulation and for fetal growth and development. Pregnancy is also commonly viewed as a “physiologic stress test,” whereby maternal physiologic changes may expose or unmask underlying previously silent cardiovascular and metabolic abnormalities. A “failed stress test”—eg, manifesting either as hypertensive disorders in pregnancy (HDP), gestational diabetes mellitus (GDM), or both—has both short- and long-term implications for maternal cardiovascular and metabolic health.