Role of obstetrician-gynecologist in cardiovascular risk reduction

The obstetrician-gynecologist's role in women's health care must extend beyond concern about reproduction and disorders of the reproductive system. A significant proportion of women in the United States now look to the obstetrician-gynecologist as their main source of preventive health care services. Since cardiovascular disease poses a major threat to women's health, it is logical that the obstetrician-gynecologist should play an active role in the prevention of such disease in women. Multiple factors contribute to women's cardiovascular risk profile. Serum cholesterol, hypertension, hyperglycemia and cigarette smoking are all amenable to change and should be a major focus of women's health care. Just as blood pressure screening and cervical cytology surveillance have evolved into basic preventive medicine strategies for women, cholesterol screening, dietary counseling and help in promoting smoking cessation should become part of the basic medical service offered by obstetrician-gynecologists. Also, as data accumulate defining more accurately the role of sex steroids in cardiovascular risk reduction, the obstetrician-gynecologist's impact on women's health will expand further. Cardiac risk factor identification, counseling and initial therapeutic interventions may provide the greatest long-term health benefits to women.