Sex differences in cardiovascular epigenetics-a systematic review.

Area of Science:

• Cardiovascular Science
• Epigenetics
• Sex Differences Research

Background:

• Cardiovascular diseases (CVD) exhibit distinct patterns in males and females, influenced by sex hormones and chromosomes.
• Epigenetic mechanisms regulate biological processes implicated in CVD and may be sex-influenced.
• A systematic review was conducted to assess the current state of research on sex differences in cardiovascular epigenetics.

Purpose of the Study:

• To systematically review existing literature on cardiovascular epigenetics.
• To identify the extent to which studies stratify epigenetic data by sex.
• To highlight research gaps in understanding sex-specific epigenetic mechanisms in CVD.

Main Methods:

• A systematic search of PubMed and Embase was performed using keywords related to cardiovascular disease, epigenetics, and sex differences.
• Publications were screened for relevance to cardiovascular epigenetics and inclusion of both sexes.
• Papers were further assessed for sex-stratification of results.

Main Results:

• Out of 3071 initial publications, 75 relevant papers including both sexes were identified.
• Only 17% (13 papers) stratified their cardiovascular epigenetics data by sex.
• The majority of sex-stratified studies focused exclusively on DNA methylation, neglecting other epigenetic mechanisms.

Conclusions:

• The majority of cardiovascular epigenetics research fails to report sex-stratified data, despite known sex differences in CVD.
• There is a significant knowledge gap regarding epigenetic mechanisms beyond DNA methylation, such as chromatin architecture and histone modifications.
• Integrating sex as a biological variable in epigenetic studies is crucial for advancing the understanding of CVD in both males and females.