scholarly journals Sex/Gender-Specific Imbalance in CVD: Could Physical Activity Help to Improve Clinical Outcome Targeting CVD Molecular Mechanisms in Women?

2020 ◽  
Vol 21 (4) ◽  
pp. 1477
Author(s):  
Mauro Vaccarezza ◽  
Veronica Papa ◽  
Daniela Milani ◽  
Arianna Gonelli ◽  
Paola Secchiero ◽  
...  
Keyword(s):  
Physical Activity ◽  
Molecular Mechanisms ◽  
Population Aging ◽  
Sex And Gender ◽  
Cvd Risk ◽  
Men And Women ◽  
Positive Effects ◽  
And Gender ◽  
Underlying Mechanisms ◽  
Gender Specific

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.

scholarly journals One drug does not fit all: impact of sex and gender on pharmacological response

2017 ◽  
Vol 39 (1) ◽  
pp. 14-17
Author(s):  
Flavia Franconi ◽  
Ilaria Campesi
Keyword(s):  
Women’S Health ◽  
Women's Health ◽  
Demographic Characteristics ◽  
Sex And Gender ◽  
Men And Women ◽  
Pharmacological Response ◽  
Health And Illness ◽  
And Gender ◽  
Study Participants ◽  
Gender Specific

It is important to remember that gender health and illness should not to be conflated with women's health and illness. Turshen1 reports that numerous studies with ‘gender’ in the title use the word gender as a synonym for ‘women’ and as a result, men's gender-specific needs are missed. In addition, in reporting demographic characteristics of the study participants, some clinical trialists use the term ‘gender’ and some ‘sex’ to indicate men and women and this may create confusion. It can be difficult to separate the two concepts, because there are continuous and constant interactions and relationships between sex and gender3. In other words, sex and gender work together. However, little attention is paid to the fact that gender is a sex modifier. It is relevant to have in mind that both sex and gender affect health and illness4.

Challenges in Sex- and Gender-Centered Prevention and Management of Cardiovascular Disease: Implications of Genetic, Metabolic, and Environmental Paths

Angiology ◽  
2018 ◽  
Vol 69 (10) ◽  
pp. 843-853 ◽  
Author(s):  
Matina Kouvari ◽  
Mary Yannakoulia ◽  
Kyriakos Souliotis ◽  
Demosthenes B. Panagiotakos
Keyword(s):  
Cardiovascular Disease ◽  
Management Strategies ◽  
Sex And Gender ◽  
Cvd Risk ◽  
Male Privilege ◽  
Atypical Symptoms ◽  
Key Points ◽  
And Gender ◽  
Underlying Mechanisms ◽  
Female Specific

The recognition of cardiovascular disease (CVD) as a “male” privilege has been a commonly held concept. However, emerging data describe another reality. Heterogeneities have been convincingly demonstrated regarding CVD manifestations, risk factor burden, and prognosis between males and females. The aim of the present narrative review was to highlight sex- and gender-related discrepancies in primary and secondary CVD prevention, underscoring plausible underlying mechanisms. Manifestation of CVD in women is characterized by atypical symptoms/signs and inadequately studied pathophysiology features challenging accurate diagnosis and effective treatment. Regarding CVD risk assessment, the burden and effect size of conventional, novel, and female-specific risk factors needs better clarification. Hitherto outcomes are nonconsistent, while most importantly, the interpretation of the attendant metabolic paths remains a challenge; the interactions among genetic, metabolic, and environmental factors are of high complexity regulated by genomic and nongenomic sex hormones effects. To deal with these key points, the National Institutes of Health currently calls upon investigators to provide a sex- and gender-specific reporting in all health research hypotheses. The implementation of high-quality studies addressing these issues is an imperative need to maximize cost-effectiveness in prevention and management strategies.

Sex and Gender Differences in Rilpivirine based ART - Data from the HIVCENTER Frankfurt

2019 ◽  
Vol 17 (5) ◽  
pp. 368-374
Author(s):  
G. Schüttfort ◽  
K. Philipp ◽  
P. de Leuw ◽  
E. Herrmann ◽  
G. Kann ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Virologic Failure ◽  
Response Rates ◽  
Virologic Response ◽  
Close Monitoring ◽  
Sex And Gender ◽  
Overall Response ◽  
Number Of Patients ◽  
And Gender ◽  
Gender Specific

Objectives: While Rilpivirine has shown high overall response rates in treatment-naïve patients without sex and gender specific differences in clinical trials, Sex and gender specific data in treatment experienced patients receiving rilpivirine are still limited. We conducted a 48 week efficacy and safety analysis in naïve and treatment experienced men and women using retrospective data from the HIVCENTER Frankfurt. Materials and methods: In this retrospective observational study data of all patients who received a rilpivirine based regimen at the HIVCENTER between March 2011 and December 2015 were analyzed. Primary endpoint was the proportion of patients with any discontinuation until week 48. Virologic response rates (FDA snapshot analysis; HIV-1 RNA <50 copies/mL) were assessed at week 48. Results: 194 patients (34% female) were included in the analysis. 74% were treatment-experienced and 26% naïve, respectively. Discontinuations were observed in 31 (15.9%) patients. Regarding sex differences, the proportion of discontinuations was significantly higher in women than in men (24.2% vs. 11.7%; p=0.024; ODDS-Ratio = 2.41; CI 1.12 – 5.18). Virologic failure occurred in 8 PLWHIV (4.1%). Conclusions: While virologic overall response rates to rilpivirine based ART were high for both treatment-experienced and -naïve patients the proportion of discontinuations was significantly higher in women (24.2% vs. 11.7%; p = 0.024; ODDS-Ratio = 2.41; CI 1.12 – 5.18). Although the total number of patients with virologic failure was low (4.1%), the higher rate of ART discontinuations in female patients receiving RPV require close monitoring in the first months of treatment addressing special needs of women living with HIV.

scholarly journals Elucidating the Relationship Between Insomnia, Sex, and Cardiovascular Disease

2020 ◽  
Vol 4 ◽  
pp. 247028972098001
Author(s):  
Rebecca Leeds ◽  
Ari Shechter ◽  
Carmela Alcantara ◽  
Brooke Aggarwal ◽  
John Usseglio ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Sex Differences ◽  
Cardiovascular Health ◽  
Future Research ◽  
Sex And Gender ◽  
Men And Women ◽  
Sex Research ◽  
And Gender ◽  
The Relationship ◽  
Cvd Mortality

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.

Measuring Sex and Gender in Aging and Alzheimer’s Research: Results of a National Survey

2021 ◽  
Author(s):  
Shana D Stites ◽  
Hannah Cao ◽  
Kristin Harkins ◽  
Jason D Flatt
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cohort Studies ◽  
Online Survey ◽  
Self Report ◽  
Sex And Gender ◽  
Men And Women ◽  
Sociocultural Diversity ◽  
And Gender ◽  
Published Research

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.

Ageing and gender

2020 ◽  
pp. 41-68
Author(s):  
Chris Gilleard ◽  
Paul Higgs
Keyword(s):  
Social Reproduction ◽  
Later Life ◽  
Social Imaginary ◽  
Financial Assets ◽  
Sex And Gender ◽  
Men And Women ◽  
The Social ◽  
And Gender ◽  
Bonding Capital

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.

Sex and gender differences overview

ESC CardioMed ◽  
2018 ◽  
pp. 2827-2830
Author(s):  
Eva Prescott
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Obstructive Coronary Artery Disease ◽  
Systolic Heart Failure ◽  
Sex And Gender ◽  
Men And Women ◽  
Artery Disease ◽  
And Gender ◽  
Sex And Gender Differences

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.

scholarly journals Patient perspectives on priorities for research on conventional and sex- and gender-related cardiovascular risk factors

2020 ◽  
Vol 28 (12) ◽  
pp. 656-661
Author(s):  
R. Bolijn ◽  
I. Schalkers ◽  
H. L. Tan ◽  
A. E. Kunst ◽  
I. G. M. van Valkengoed
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Minority Groups ◽  
Sex And Gender ◽  
Men And Women ◽  
Related Risk ◽  
Increased Risk ◽  
And Gender ◽  
New Research

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.

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