Risk factors for coronary heart disease are well documented for men and women. The management of these risk factors is cost effective, but it is generally ignored or pursued less vigorously in women than men.

Smoking: The incidence of smoking in young female adults of age group 20-24 years has increased. The risk due to smoking increases tremendously if there is combine consumption of oral contraceptives, especially in women greater than 35 years of age.

Cholesterol: Raised level of total cholesterol and LDL cholesterol are weakly associated with coronary heart disease in women. Instead one should watch out for HDL cholesterol, as it is closely and inversely related to coronary heart disease. Triglycerides, especially in older women or diabetics, are also an independent predictor of coronary heart disease.

Diabetes Mellitus: Diabetes is an exceptionally bad and powerful risk factor for women. It increases the the risk of coronary heart disease in women to three to seven folds, as compared with the increase of two to three folds in men. Diabetes dramatically increases the death rate of heart attack in women. Women have a higher prevalence of diabetes mellitus than men.

Hypertension: The importance of hypertension (high blood pressure) is similar in both men and women. Optimal high blood pressure treatment can reduce the various complications such as death, stroke, heart failure or coronary heart disease.

Stress: Acute and chronic stresses may play a contributory role in the development of coronary heart disease or plaque rupture. Depression and lack of social support may contribute partly to the poorer outcome after cardiac events or cardiac surgery in women.

One of the best times to review and counsel women's risk factors is during preconception period and pregnancy. Women should be strongly discouraged to smoke and to avoid excessive weight gain. Advice on nutrition, physical activity and stress management are also important aspects in heart health counseling.