scholarly journals Sex and gender aspects in vascular pathophysiology

2020 ◽  
Vol 134 (16) ◽  
pp. 2203-2207
Author(s):  
Paul J. Connelly ◽  
Karin A.M. Jandeleit-Dahm ◽  
Christian Delles

Abstract Cardiovascular disease (CVD) is a leading cause of global mortality in men and women. The prevalence, pathophysiology, clinical manifestations and outcomes of CVD observed in these two populations is being increasingly recognized as distinct. In this editorial, we provide an overview of mechanisms related to differences in vascular pathophysiology between men and women and explore the contributions of both sex and gender.

2020 ◽  
Vol 4 ◽  
pp. 247028972098001
Author(s):  
Rebecca Leeds ◽  
Ari Shechter ◽  
Carmela Alcantara ◽  
Brooke Aggarwal ◽  
John Usseglio ◽  
...  

Sex differences in cardiovascular disease (CVD) mortality have been attributed to differences in pathophysiology between men and women and to disparities in CVD management that disproportionately affect women compared to men. Similarly, there has been investigation of differences in the prevalence and presentation of insomnia attributable to sex. Few studies have examined how sex and insomnia interact to influence CVD outcomes, however. In this review, we summarize the literature on sex-specific differences in the prevalence and presentation of insomnia as well as existing research regarding the relationship between insomnia and CVD outcomes as it pertains to sex. Research to date indicate that women are more likely to have insomnia than men, and there appear to be differential associations in the relation between insomnia and CVD by sex. We posit potential mechanisms of the relationship between sex, insomnia and CVD, discuss gaps in the existing literature, and provide commentary on future research needed in this area. Unraveling the complex relations between sex, insomnia, and CVD may help to explain sex-specific differences in CVD, and identify sex-specific strategies for promotion of cardiovascular health. Throughout this review, terms “men” and “women” are used as they are in the source literature, which does not differentiate between sex and gender. The implications of this are also discussed.


2021 ◽  
Vol 22 (11) ◽  
pp. 5808
Author(s):  
Annalisa Giandalia ◽  
Alfio Edoardo Giuffrida ◽  
Guido Gembillo ◽  
Domenico Cucinotta ◽  
Giovanni Squadrito ◽  
...  

Diabetic kidney disease (DKD) is one of the most serious complications of both type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Current guidelines recommend a personalized approach in order to reduce the burden of DM and its complications. Recognizing sex and gender- differences in medicine is considered one of the first steps toward personalized medicine, but the gender issue in DM has been scarcely explored so far. Gender differences have been reported in the incidence and the prevalence of DKD, in its phenotypes and clinical manifestations, as well as in several risk factors, with a different impact in the two genders. Hormonal factors, especially estrogen loss, play a significant role in explaining these differences. Additionally, the impact of sex chromosomes as well as the influence of gene–sex interactions with several susceptibility genes for DKD have been investigated. In spite of the increasing evidence that sex and gender should be included in the evaluation of DKD, several open issues remain uncovered, including the potentially different effects of newly recommended drugs, such as SGLT2i and GLP1Ras. This narrative review explored current evidence on sex/gender differences in DKD, taking into account hormonal, genetic and clinical factors.


Author(s):  
Shana D Stites ◽  
Hannah Cao ◽  
Kristin Harkins ◽  
Jason D Flatt

Abstract Objective Differences between men and women are common in published research on aging and Alzheimer’s disease and Alzheimer’s disease and related dementias (AD/ADRD). What do these differences mean? To answer this, rigorous measurement is needed. We investigated current methods for measuring sex/gender in aging and AD/ADRD cohort studies. Method An online survey was sent to NIA-funded Alzheimer’s Disease Research Centers (ADRCs) (n=38) and investigator-initiated cohort studies (n=38) to assess practices around enrollment of men and women and measurement of sex and gender. Results The response rate was 65.8% (n=50). All enrolled men and all but two investigator-initiated studies enrolled women. Most cohorts (43/50) had no documented definitions for categories of “men” or “women”. Over 85% of cohorts relied solely on self-report questions to capture sex/gender data (n=43/50). Issues with administration were also identified (n=7). Discussion Our findings identify gaps in current approaches used to measure sex and gender in aging and AD/ADRD research. We discuss opportunities to bridge these gaps and advance measurement of sex and gender in aging and AD/ADRD research. Changes are needed to ensure inclusion and representation of sociocultural diversity in research samples, and consistency in data collection in aging and AD/ADRD research.


Author(s):  
Chris Gilleard ◽  
Paul Higgs

This chapter begins by considering the distinction between sex and gender. The latter constitutes the source of the social division between men and women considered as social beings. It serves as both a reflection of division and inequality and a source of difference and identity. The chapter then explores the framing of this division in terms of patriarchy and the inequalities that are organised by and structured within the relations of work and of social reproduction. It focuses next upon the consequences of such a division, first in terms of both financial assets and resources and then in terms of social relational capital, drawing upon Putnam’s distinction between bridging and bonding capital. It then considers other sources of difference that become more salient in later life, in terms of health illness and longevity. The chapter ends with the role of gender in representing later life, and the role of later life in representing gender. It concludes by distinguishing between gender as a structure shaping third age culture, and gender as a constituent in the social imaginary of the fourth age.


ESC CardioMed ◽  
2018 ◽  
pp. 2827-2830
Author(s):  
Eva Prescott

There are well-described differences between men and women in epidemiology, pathophysiology, presentation, and outcome of heart disease. Although risk factors responsible for cardiovascular disease are similar in men and women their relative importance differs. Puzzlingly, women have more angina yet less obstructive coronary artery disease. Also, when they suffer myocardial infarction, women more often present with myocardial infarction with non-obstructed coronary arteries (MINOCA) and takotsubo cardiomyopathy. Women have less systolic heart failure than men but more heart failure with preserved ejection fraction, a condition yet to find evidence-based treatment. Atrial fibrillation is also less common in women than men of similar age, but women with atrial fibrillation have higher risk of stroke than their male counterparts.


2020 ◽  
Vol 28 (12) ◽  
pp. 656-661
Author(s):  
R. Bolijn ◽  
I. Schalkers ◽  
H. L. Tan ◽  
A. E. Kunst ◽  
I. G. M. van Valkengoed

Abstract Background Recently, cardiovascular disease (CVD) research has focused on sex- and gender-related cardiovascular risk factors, in addition to conventional risk factors. This raises the question which factors are perceived by the target group (patients with CVD) as priorities for further research. Methods We carried out a survey to study priority setting for more research into conventional and sex- and gender-related risk factors according to 980 men and women with CVD or those at increased risk of CVD in the Netherlands. Data on conventional and sex- and gender-related risk factors were descriptively analysed, stratified by gender group. Results The most frequently prioritised conventional factors according to men were heritability, overweight and unhealthy diet, while women most frequently listed stress, heritability and hypertension. The most frequently prioritised sex- and gender-related risk factors were depression or depressive feelings, migraine and having many caretaking responsibilities (men), and pregnancy complications, contraceptive pill use and early age at menopause (women). New research on sex- and gender-related risk factors was perceived roughly as relevant as that on conventional factors by men (mean 7.4 and 8.3 on a 1–10 scale, respectively) and women (8.2 and 8.6, respectively). Ethnic and gender minority groups placed more emphasis on risk factors related to sociocultural aspects (gender) than the majority group. Conclusion Men and women with CVD or those at increased risk of CVD perceived new research on conventional and sex- and gender-related risk factors as a priority. These findings may guide researchers and funders in further prioritising new CVD research.


2020 ◽  
Vol 21 (4) ◽  
pp. 1477
Author(s):  
Mauro Vaccarezza ◽  
Veronica Papa ◽  
Daniela Milani ◽  
Arianna Gonelli ◽  
Paola Secchiero ◽  
...  

In the last two decades, new insights have been gained regarding sex/gender-related differences in cardiovascular disease (CVD). CVD represents the leading cause of death worldwide in both men and women, accounting for at least one-third of all deaths in women and half of deaths in women over 50 years in developing countries. Important sex-related differences in prevalence, presentation, management, and outcomes of different CVDs have been recently discovered, demonstrating sex/gender-specific pathophysiologic features in the presentation and prognosis of CVD in men and women. A large amount of evidence has highlighted the role of sex hormones in protecting women from CVDs, providing an advantage over men that is lost when women reach the menopause stage. This hormonal-dependent shift of sex-related CVD risk consequently affects the overall CVD epidemiology, particularly in light of the increasing trend of population aging. The benefits of physical activity have been recognized for a long time as a powerful preventive approach for both CVD prevention and aging-related morbidity control. Exercise training is indeed a potent physiological stimulus, which reduces primary and secondary cardiovascular events. However, the underlying mechanisms of these positive effects, including from a sex/gender perspective, still need to be fully elucidated. The aim of this work is to provide a review of the evidence linking sex/gender-related differences in CVD, including sex/gender-specific molecular mediators, to explore whether sex- and gender-tailored physical activity may be used as an effective tool to prevent CVD and improve clinical outcomes in women.


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