Gender-Specific Perspectives on National and Global Dyslipidemia Guidelines

Dyslipidemia is a major contributor to atherosclerotic cardiovascular disease (CVD), yet disparities in diagnosis, treatment, and outcomes between sexes and genders remain. Although low-density lipoprotein (LDL) cholesterol management targets differ slightly across guidelines, they are generally applied uniformly to both men and women, with evidence suggesting comparable therapeutic benefits. However, women tend to develop CVD later in life and widely used risk scores have limited validation in older adults, leaving uncertainty in risk estimation for older women. In younger women, recent guidelines have begun to incorporate female-specific risk enhancers, such as premature menopause, pregnancy complications, and autoimmune diseases, into cardiovascular risk assessment, though comprehensive guidance remains lacking. Across all guidelines, there is universal agreement that statins are generally contraindicated during pregnancy and lactation, with bile acid sequestrants and LDL apheresis recommended as alternative therapies in cases of severe familial hypercholesterolemia. Additional challenges more frequently observed in women include lower treatment adherence, higher rates of statin intolerance, and lifelong cardiovascular risk shaped by hormonal transitions, all of which require greater clinical attention. Future progress will depend on expanding sex-specific evidence, refining risk models, and implementing equitable treatment strategies. Incorporating a gender perspective into dyslipidemia management is essential for improving cardiovascular outcomes in women.