Sex Differences in Platelet Toll-Like Receptors and Their Association With Cardiovascular Risk Factors

Abstract Background Sex differences in major cardiovascular risk factors for incident (fatal or non-fatal) all-cause dementia were assessed in the UK Biobank. The effects of these risk factors on all-cause dementia were explored by age and socioeconomic status (SES). Methods Cox proportional hazards models were used to estimate hazard ratios (HRs) and women-to-men ratio of HRs (RHR) with 95% confidence intervals (CIs) for systolic blood pressure (SBP) and diastolic blood pressure (DBP), smoking, diabetes, adiposity, stroke, SES and lipids with dementia. Poisson regression was used to estimate the sex-specific incidence rate of dementia for these risk factors. Results 502,226 individuals in midlife (54.4% women, mean age 56.5 years) with no prevalent dementia were included in the analyses. Over 11.8 years (median), 4068 participants (45.9% women) developed dementia. The crude incidence rates were 5.88 [95% CI 5.62–6.16] for women and 8.42 [8.07–8.78] for men, per 10,000 person-years. Sex was associated with the risk of dementia, where the risk was lower in women than men (HR = 0.83 [0.77–0.89]). Current smoking, diabetes, high adiposity, prior stroke and low SES were associated with a greater risk of dementia, similarly in women and men. The relationship between blood pressure (BP) and dementia was U-shaped in men but had a dose-response relationship in women: the HR for SBP per 20 mmHg was 1.08 [1.02–1.13] in women and 0.98 [0.93–1.03] in men. This sex difference was not affected by the use of antihypertensive medication at baseline. The sex difference in the effect of raised BP was consistent for dementia subtypes (vascular dementia and Alzheimer’s disease). Conclusions Several mid-life cardiovascular risk factors were associated with dementia similarly in women and men, but not raised BP. Future bespoke BP-lowering trials are necessary to understand its role in restricting cognitive decline and to clarify any sex difference.

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Do Cardiovascular Risk Factors and Cardiovascular Disease Explain Sex Differences in Cognitive Functioning in Old Age?

Journal of Alzheimer s Disease ◽

10.3233/jad-201173 ◽

2021 ◽

pp. 1-13

Author(s):

Elisabeth Maria van Zutphen ◽

Judith Johanna Maria Rijnhart ◽

Didericke Rhebergen ◽

Majon Muller ◽

Martijn Huisman ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Sex Differences ◽

Information Processing ◽

Cardiovascular Risk ◽

Episodic Memory ◽

Cognitive Functioning ◽

Cardiovascular Risk Factors ◽

Processing Speed ◽

Information Processing Speed

Background: Sex differences in cognitive functioning in old age are known to exist yet are still poorly understood. Objective: This study examines to what extent differences in cardiovascular risk factors and cardiovascular disease between men and women explain sex differences in cognitive functioning. Methods: Data from 2,724 older adults from the Longitudinal Aging Study Amsterdam were used. Information processing speed and episodic memory, measured three times during six years of follow-up, served as outcomes. The mediating role of cardiovascular risk factors and cardiovascular disease was examined in single and multiple mediator models. Determinant-mediator effects were estimated using linear or logistic regression, and determinant-outcome and mediator-outcome effects were estimated using linear mixed models. Indirect effects were estimated using the product-of-coefficients estimator. Results: Women scored 1.58 points higher on information processing speed and 1.53 points higher on episodic memory. Several cardiovascular risk factors had small mediating effects. The sex difference in information processing speed was mediated by smoking, depressive symptoms, obesity, and systolic blood pressure. The sex difference in episodic memory was mediated by smoking, physical activity, and depressive symptoms. Effects of smoking, LDL cholesterol, and diabetes mellitus on information processing speed differed between men and women. Conclusion: Differences in cardiovascular risk factors between women and men partially explained why women had better cognitive functioning. A healthy cardiovascular lifestyle seems beneficial for cognition and sex-specific strategies may be important to preserve cognitive functioning at older age.

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Impact of cardiovascular risk factors on carotid intima–media thickness: sex differences

Clinical Interventions in Aging ◽

10.2147/cia.s103521 ◽

2016 ◽

pp. 721 ◽

Cited By ~ 3

Author(s):

Izabella Uchmanowicz ◽

Maria Łoboz-Rudnicka ◽

Joanna Jaroch ◽

Zbigniew Bociąga ◽

Barbara Rzyczkowska ◽

...

Keyword(s):

Risk Factors ◽

Sex Differences ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Media Thickness

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Abstract W P121: Stroke Severity in Men and Women: What Proportion of the Disparity Can Be Explained by Differences in Cardiovascular Risk Factors?

Stroke ◽

10.1161/str.45.suppl_1.wp121 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Karen C Albright ◽

Amelia K Boehme ◽

Bisakha Sen ◽

Monica Aswani ◽

Michael T Mullen ◽

...

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Sex Differences ◽

Cardiovascular Risk ◽

Black Women ◽

Cardiovascular Risk Factors ◽

Stroke Severity ◽

Stroke Subtype ◽

Oaxaca Decomposition ◽

Nihss Score

Background: Prior studies have shown that women present with more severe stroke. It has been suggested that sex differences in stroke severity are related to age, stroke subtype, or cardiovascular risk factors. We aimed to determine the proportion of sex disparity in stroke severity that can be explained by differences in these variables using Oaxaca decomposition, an econometric technique which quantifies the differences between groups. Methods: White and Black ischemic stroke patients who presented to two academic medical centers in the US (2004-2011) were identified using prospective stroke registries. In-hospital strokes were excluded. Patient demographics and medical history were collected. Stroke severity was measured by NIHSS. Linear regression was used to determine if female sex was associated with NIHSS score. This model was then adjusted for potential confounders including: age, race, stroke subtype, and cardiovascular risk factors. Oaxaca decomposition was then used to determine the proportion of the observed sex differences in stroke severity that can be explained by these variables. Results: 4925 patients met inclusion criteria. Nearly half (n=2346) were women and 39% (n=1942) were Black. Women presented with more severe strokes (median NIHSS 8 vs. 6). In addition, women were older on average (68 vs. 63 years) with more frequent atrial fibrillation (18% vs. 13%), diabetes (34% vs. 30%), and hypertension (78% vs. 72%). Oaxaca decomposition revealed that age, race, atrial fibrillation, large vessel etiology, diabetes, hypertension account for only 63% of the sex differences seen in NIHSS score on presentation. Conclusion: In our biracial sample, women presented with more severe strokes than men. This difference remained significant even after adjustment for age, stroke subtype, and cardiovascular risk factors. Further, over 1/3 of the observed gender difference in stroke severity was unexplained.. Additional study is warranted to investigate the etiology of the gender differences in stroke severity.

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Sex differences in cardiovascular risk factors independent of abdominal fat distribution

Scandinavian Journal of Primary Health Care ◽

10.3109/02813439609024174 ◽

1996 ◽

Vol 14 (3) ◽

pp. 177-183 ◽

Cited By ~ 3

Author(s):

Peter Nilsson ◽

Lars H. Lindholm ◽

Bengt Schersten

Keyword(s):

Risk Factors ◽

Sex Differences ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Fat Distribution ◽

Abdominal Fat

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Study of Cardiovascular Risk Factors in Patients of Diabetes type 2 with Special Reference to Sex Differences

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v5i4.216 ◽

2017 ◽

Vol 05 (04) ◽

pp. 21105-21110

Author(s):

Gosai. Kanugir. R ◽

Keyword(s):

Risk Factors ◽

Sex Differences ◽

Cardiovascular Risk ◽

Special Reference ◽

Cardiovascular Risk Factors ◽

Diabetes Type 2 ◽

Diabetes Type

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Sex Differences in Cardiovascular Risk Factors for Dementia

Biomolecules & Therapeutics ◽

10.4062/biomolther.2018.159 ◽

2018 ◽

Vol 26 (6) ◽

pp. 521-532 ◽

Cited By ~ 7

Author(s):

Mi-Young Kim ◽

Kyeongjin Kim ◽

Chang Hyung Hong ◽

Sang Yoon Lee ◽

Yi-Sook Jung

Keyword(s):

Risk Factors ◽

Sex Differences ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors

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Coronary Artery Disease in Women: A Comprehensive Appraisal

Journal of Clinical Medicine ◽

10.3390/jcm10204664 ◽

2021 ◽

Vol 10 (20) ◽

pp. 4664

Author(s):

Nili Schamroth Pravda ◽

Orith Karny-Rahkovich ◽

Arthur Shiyovich ◽

Miri Schamroth Pravda ◽

Naomi Rapeport ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Sex Differences ◽

Cardiovascular Risk ◽

Coronary Artery ◽

Cardiovascular Risk Factors ◽

Clinical Presentation ◽

Artery Disease

Coronary artery disease (CAD) is a significant cause of illness and death amongst women. The pathophysiology, manifestations, and outcomes of CVD and CAD differ between sexes. These sex differences remain under-recognized. The aim of this review is to highlight and raise awareness of the burden and unique aspects of CAD in women. It details the unique pathophysiology of CAD in women, cardiovascular risk factors in women (both traditional and sex-specific), the clinical presentation of CAD in women, and the range of disease in obstructive and non-obstructive CAD in women.

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