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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
PubMed

Insights

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.
Abstract

Keywords:
AgingCardiovascular diseaseHeart failureSex

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