The lack of the same improvement in women in their morbidity or mortality from coronary heart disease (CHD) has made us realise that women require a different approach in terms of management to men. Although CHD has for many years been considered a man’s disease, there are significant differences found in women patients that make them a special population.

Two important facts have emerged from available data: firstly that women themselves have little insight into their own risk of heart disease, more specifically coronary heart disease, as do their health-carers; and secondly, that statistics over the last 25 years from the western world show a 35–50% decline in mortality from cardiovascular disease in men, which is unmatched by an equivalent reduction in women. Therefore, cardiovascular disease, particularly CHD, in women has, to date, largely been under-recognised, under-diagnosed and under-treated.

In the USA, one woman dies every minute from cardiovascular disease, and in the UK and Europe, one every six …