{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:28:50Z","timestamp":1787585330457,"version":"build-2736575974"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:00:00Z","timestamp":1708473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Current clinical guidelines on cardiovascular disease (CVD) do not specifically address the female population. The aim of this consensus is to know the opinion of a group of experts on the management of CVD in women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Through a Delphi consensus, 31 experts in cardiology, 9 in gynecology and obstetrics, and 14 primary care physicians, showed their degree of agreement on 44 items on CVD in women divided into the following groups: (1) risk factors and prevention strategies; (2) diagnosis and clinical manifestations; and (3) treatment and follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After two rounds, consensus in agreement was reached on 27 items (61.4%). Most of the non-consensus items (31.8%) belonged to group 3. The lack of consensus in this group was mainly among gynecologists and primary care physicians. The panelists agreed on periodic blood pressure control during pregnancy and delivery to detect hypertensive disorders, especially in women with a history of preeclampsia and\/or gestational hypertension, and diabetes mellitus control in those with gestational diabetes. Also, the panelists agreed that women receive statins at a lower intensity than men, although there was no consensus as to whether the efficacy of drug treatments differs between women and men.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The high degree of consensus shows that the panelists are aware of the differences that exist between men and women in the management of CVD and the need to propose interventions to reduce this inequality. The low level of consensus reveals the lack of knowledge, and the need for information and training on this topic.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2024.1315503","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T04:54:34Z","timestamp":1708491274000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Multidisciplinary management of cardiovascular disease in women: Delphi consensus"],"prefix":"10.3389","volume":"11","author":[{"given":"Jos\u00e9 M.","family":"G\u00e1mez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milagros","family":"Pedreira P\u00e9rez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Rosa","family":"Fern\u00e1ndez Olmo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Fasero Laiz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ver\u00f3nica","family":"Inaraja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicente","family":"Pallar\u00e9s Carratal\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,2,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/j.medcli.2018.05.011","article-title":"The burden of disease in Spain: results from the global burden of disease 2016","volume":"151","author":"Soriano","year":"2018","journal-title":"Med Clin (Barc)"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e93","DOI":"10.1161\/CIR.0000000000001123","article-title":"Heart disease and stroke statistics-2023 update: a report from the American heart association","volume":"147","author":"Tsao","year":"2023","journal-title":"Circulation"},{"key":"B3","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1161\/CIRCULATIONAHA.114.011201","article-title":"Systematic review of patients presenting with suspected myocardial infarction and nonobstructive coronary arteries","volume":"131","author":"Pasupathy","year":"2015","journal-title":"Circulation"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2385","DOI":"10.1016\/S0140-6736(21)00684-X","article-title":"The lancet women and cardiovascular disease commission: reducing the global burden by 2030","volume":"397","author":"Vogel","year":"2021","journal-title":"Lancet"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1089\/jwh.2010.2595","article-title":"Signs and symptoms of suspected myocardial ischemia in women: results from the what is the optimal method for ischemia evaluation in women?","volume":"20","author":"Mieres","year":"2011","journal-title":"Trial. J Womens Health (Larchmt)"},{"key":"B6","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1016\/j.cjca.2019.01.010","article-title":"Temporal trends of women enrollment in major cardiovascular randomized clinical trials","volume":"35","author":"Gong","year":"2019","journal-title":"Can J Cardiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"10","DOI":"10.15420\/ecr.2016:32:1","article-title":"Cardiovascular disease in women: understanding symptoms and risk factors","volume":"12","author":"Keteepe-Arachi","year":"2017","journal-title":"Eur Cardiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e41","DOI":"10.15420\/ecr.2021.24","article-title":"Secondary prevention of cardiovascular disease in women: closing the gap","volume":"16","author":"Thakkar","year":"2021","journal-title":"Eur Cardiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"2803","DOI":"10.1161\/CIRCULATIONAHA.108.789800","article-title":"Sex differences in medical care and early death after acute myocardial infarction","volume":"118","author":"Jneid","year":"2008","journal-title":"Circulation"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2141","DOI":"10.1161\/CIRCULATIONAHA.115.021177","article-title":"Race and sex differences in the incidence and prognostic significance of silent myocardial infarction in the atherosclerosis risk in communities (ARIC) study","volume":"133","author":"Zhang","year":"2016","journal-title":"Circulation"},{"key":"B11","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/j.jacc.2017.05.051","article-title":"Quality and equitable health care gaps for women: attributions to sex differences in cardiovascular medicine","volume":"70","author":"Shaw","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"967","DOI":"10.1093\/eurheartj\/ehaa1044","article-title":"Cardiovascular health after menopause transition, pregnancy disorders, and other gynaecologic conditions: a consensus document from European cardiologists, gynaecologists, and endocrinologists","volume":"42","author":"Maas","year":"2021","journal-title":"Eur Heart J"},{"key":"B13","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1136\/bmj.311.7001.376","article-title":"Consensus methods for medical and health services research","volume":"311","author":"Jones","year":"1995","journal-title":"Br Med J"},{"key":"B14","author":"Fitch","year":""},{"key":"B15","doi-asserted-by":"publisher","first-page":"1008","DOI":"10.1046\/j.1365-2648.2000.t01-1-01567.x","article-title":"Research guidelines for the Delphi survey technique","volume":"32","author":"Hasson","year":"2000","journal-title":"J Adv Nurs"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1633","DOI":"10.1016\/j.jacc.2015.02.025","article-title":"Using age- and sex-specific risk thresholds to guide statin therapy: one size may not fit all","volume":"65","author":"Navar-Boggan","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1161\/01.CIR.0000154568.43333.82","article-title":"National study of physician awareness and adherence to cardiovascular disease prevention guidelines","volume":"111","author":"Mosca","year":"2005","journal-title":"Circulation"},{"key":"B18","doi-asserted-by":"publisher","first-page":"2315","DOI":"10.1093\/eurheartj\/ehw106","article-title":"2016 European guidelines on cardiovascular disease prevention in clinical practice: the sixth joint task force of the European society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of 10 societies and by invited experts) developed with the special contribution of the European association for cardiovascular prevention & rehabilitation (EACPR)","volume":"37","author":"Piepoli","year":"2016","journal-title":"Eur Heart J"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e1082","DOI":"10.1161\/CIR.0000000000000625","article-title":"2018 AHA\/ACC\/AACVPR\/AAPA\/ABC\/ACPM\/ADA\/AGS\/APHA\/ASPC\/NLA\/PCNA guideline on the management of blood cholesterol: a report of the American college of cardiology\/American heart association task force on clinical practice guidelines","volume":"139","author":"Grundy","year":"2019","journal-title":"Circulation"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1376","DOI":"10.1016\/j.jacc.2019.03.009","article-title":"2019 ACC\/AHA guideline on the primary prevention of cardiovascular disease: executive summary: a report of the American college of cardiology\/American heart association task force on clinical practice guidelines","volume":"74","author":"Arnett","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.rccl.2019.10.004","article-title":"Recomendaciones de seguimiento a partir del \u201ccuarto trimestre\u201d de mujeres con complicaciones vasculares y metab\u00f3licas durante el embarazo. Documento de consenso de la SEC, SEMERGEN, semFYC y SEGO","volume":"55","author":"Castro Conde","year":"2020","journal-title":"REC CardioClinics"},{"key":"B22","doi-asserted-by":"publisher","first-page":"3361","DOI":"10.1093\/eurheartj\/ehab502","article-title":"Mammographic features are associated with cardiometabolic disease risk and mortality","volume":"42","author":"Grassmann","year":"2021","journal-title":"Eur Heart J"},{"key":"B23","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1161\/CIRCULATIONAHA.117.031650","article-title":"Sex differences in the presentation and perception of symptoms among young patients with myocardial infarction: evidence from the VIRGO study (variation in recovery: role of gender on outcomes of young AMI patients)","volume":"137","author":"Lichtman","year":"2018","journal-title":"Circulation"},{"key":"B24","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1093\/cvr\/cvab063","article-title":"Sex differences in acute cardiovascular care: a review and needs assessment","volume":"118","author":"Vallabhajosyula","year":"2022","journal-title":"Cardiovasc Res"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.1007\/s10557-021-07273-0","article-title":"Challenges in optimizing lipid management in women","volume":"36","author":"Peterson","year":"2022","journal-title":"Cardiovasc Drugs Ther"},{"key":"B26","doi-asserted-by":"publisher","first-page":"3227","DOI":"10.1093\/eurheartj\/ehab484","article-title":"2021 ESC guidelines on cardiovascular disease prevention in clinical practice","volume":"42","author":"Visseren","year":"2021","journal-title":"Eur Heart J"},{"key":"B27","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1093\/eurheartj\/ehz455","article-title":"2019 ESC\/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk","volume":"41","author":"Mach","year":"2020","journal-title":"Eur Heart J"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2021-001900","article-title":"Statins are associated with a large reduction in all-cause mortality in women from a cardiac outpatient population","volume":"9","author":"Bots","year":"2022","journal-title":"Open Heart"},{"key":"B29","doi-asserted-by":"publisher","first-page":"e005562","DOI":"10.1161\/CIRCOUTCOMES.118.005562","article-title":"Sex differences in the use of statins in community practice","volume":"12","author":"Nanna","year":"2019","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1729","DOI":"10.1016\/j.jacc.2018.02.032","article-title":"Sex differences in high-intensity statin use following myocardial infarction in the United States","volume":"71","author":"Peters","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.amjcard.2014.09.041","article-title":"Gender disparities in evidence-based statin therapy in patients with cardiovascular disease","volume":"115","author":"Virani","year":"2015","journal-title":"Am J Cardiol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"104514","DOI":"10.1016\/j.phrs.2019.104514","article-title":"Sex-differences in factors and outcomes associated with adherence to statin therapy in primary care: need for customisation strategies","volume":"155","author":"Olmastroni","year":"2020","journal-title":"Pharmacol Res"},{"key":"B33","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1016\/j.recesp.2021.05.009","article-title":"Sex differences in mortality after an acute coronary syndrome increase with lower country wealth and higher income inequality","volume":"75","author":"Rossello","year":"2022","journal-title":"Rev Esp Cardiol (Engl Ed)"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2024.1315503\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T04:54:36Z","timestamp":1708491276000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2024.1315503\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,21]]},"references-count":33,"alternative-id":["10.3389\/fcvm.2024.1315503"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2024.1315503","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,21]]},"article-number":"1315503"}}