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Sex-specific differences in hypertension and associated cardiovascular disease

Katrina M Mirabito Colafella1,2,3, Kate M Denton1,2

  • 1Cardiovascular Disease Program, Monash Biomedicine Discovery Institute, Monash University Wellington Road, Clayton, Victoria 3800, Australia.

Nature Reviews. Nephrology
|January 31, 2018
PubMed

Insights

Differences in cardiovascular systems between males and females influence hypertension and cardiovascular disease (CVD) risk and treatment. Understanding these sex-specific factors is crucial for developing effective, tailored therapies for both sexes.

Area of Science:

  • Cardiovascular Physiology
  • Sex Differences in Medicine
  • Hypertension Research

Background:

  • Arterial blood pressure (BP) regulation mechanisms show sex-specific variations at molecular, cellular, and tissue levels.
  • These physiological differences impact disease onset, susceptibility, prevalence, and treatment responses in cardiovascular disease (CVD).

Purpose of the Study:

  • To explore the multifaceted sex differences in BP regulation and CVD development.
  • To highlight the influence of biological age, sex hormones, and lifestyle factors on sex-specific cardiovascular health.

Main Methods:

  • Review of existing literature on sex-based disparities in cardiovascular systems.
  • Analysis of the roles of the sympathetic nervous system, renin-angiotensin-aldosterone system, and immune system in sex-specific BP regulation.
  • Examination of cellular mechanisms like senescence and the impact of sex hormones and lifestyle factors.

Main Results:

  • Key systems (sympathetic nervous system, renin-angiotensin-aldosterone system, immune system) are differentially activated between sexes.
  • Premenopausal women exhibit greater cardioprotection than age-matched men, influenced by sex hormones and chromosome complement.
  • Cellular senescence pathways and lifestyle factors contribute to sex-specific longevity and organ damage from hypertension.

Conclusions:

  • Sex-specific factors significantly influence hypertension and CVD, with cardioprotection in women diminishing with obesity and type 2 diabetes.
  • Tailored treatment strategies for hypertension and CVD based on sex can potentially improve patient outcomes.

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