Current guidelines recommend assessing a patient's risk of ASCVD using traditional risk factors such as hypertension, hyperlipidemia, diabetes, and obesity; furthermore, emerging data supports incorporating additional sex-specific considerations (such as menopause status) for women when engaging in clinician-patient discussions regarding overall cardiovascular risk and treatment plans. Diagnostic testing for subclinical disease, such as CAC scoring or potentially CCTA, may be useful in refining risk assessment and optimizing both lifestyle-based and pharmacologic-based preventive interventions. Additionally, dynamic vascular changes associated with menopause such as decreased aortic distensibility may be a predictor for increased cardiovascular risk. Although HT has yielded a controversial variety of results in previous studies regarding ASCVD risk, there may be a potential for its protection against the progression of atherosclerotic disease that should be further investigated.
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