Gender issues in the cardiovascular field

Abstrakt prednášky

It is increasingly acknowledged that a sex and gender specificity affects the occurrence, development, and consequences of cardiovascular diseases (CVD). The rate of CVD is lower in non- menopausal women than in men of the same age, but this rate increases with age and becomes the major cause of female mortality. These gender differences include biological but also socio-cultural parameters. They affect symptomatology, epidemiology, physiopathology, medical approach, effectiveness of the treatments, side effects, prognosis and prevention of CVD. Biological differences arise from sex chromosomes, hormones and epigenetic factors. Sexual hormone receptors are present in the different cell populations of the cardiovascular system rendering them sensitive to circulating hormones. Among the numerous cell processes present with a sexual dimorphism, energy metabolism is of special interest. Various sex differences has been noted in mitochondria that affect biogenesis, specific activities, calcium handling and oxidative stress for example. Paradoxically, the Male/Female representation in clinical and experimental studies shows a very clear disproportion to the disadvantage of women. This introduces a bias in translational research, and in clinical concepts and the development of CV therapies that are less effective and have more side effects in women.