Heart disease remains the leading cause of death in women worldwide, but the way it develops is often misunderstood. Atherosclerotic cardiovascular disease (ASCVD) refers to a group of conditions caused by the gradual buildup of cholesterol-rich plaque inside the walls of arteries. Over time, this plaque narrows or blocks blood flow to vital organs such as the heart and brain, which can lead to chest pain (angina), heart attack, stroke, or other serious complications.