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Sex Differences in Cardiovascular Aging and Heart Failure
Andrew Oneglia1, Michael D Nelson1,2, C Noel Bairey Merz3
1Applied Physiology and Advanced Imaging Lab, University of Texas at Arlington, 655 West Mitchell St, Arlington, TX, 76010, USA.
Current Heart Failure Reports
|September 28, 2020
Summary
Aging causes sex-specific heart and blood vessel changes. These differences impact cardiovascular disease (CVD) risk and heart failure development, especially in women, offering insights for prevention.
Area of Science:
- Cardiovascular Physiology
- Aging Research
- Sex Differences in Medicine
Background:
- Aging significantly alters cardiovascular structure and function.
- Sex-specific differences in cardiovascular aging are increasingly recognized.
- Cardiovascular disease (CVD) risk factors and existing CVD exacerbate age-related changes.
Purpose of the Study:
- To review sex-related changes in the heart and vasculature during aging.
- To examine these changes in the presence and absence of cardiovascular disease.
- To understand the implications for cardiovascular health and disease development.
Main Methods:
- Literature review of studies on sex differences in cardiac and vascular aging.
- Analysis of research on cardiomyocyte number, extracellular matrix, and hypertrophy.
- Examination of studies on vascular stiffening, endothelial function, and neurohormonal signaling.
Main Results:
- Sex-specific cardiac remodeling (cardiomyocyte number, ECM, hypertrophy) occurs with aging and CVD.
- Age- and sex-specific vascular stiffening is driven by endothelial dysfunction and altered signaling.
- These changes contribute to altered systolic and diastolic function, particularly in postmenopausal women.
Conclusions:
- Estrogen plays a key role in mediating sex-specific cardiovascular aging effects.
- Understanding these sex differences is crucial for heart failure with preserved ejection fraction (HFpEF) development.
- These insights offer potential for novel preventive strategies and therapeutic interventions.
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