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Sex Differences in Molecular Mechanisms of Cardiovascular Aging
Vanessa Dela Justina1, Jéssica S G Miguez2, Fernanda Priviero3
1Graduate Program in Biological Sciences, Federal University of Goiás, Goiânia, Brazil.
Insights
Cardiovascular disease (CVD) risk and aging differ by sex. This review explores molecular mechanisms behind sex-based cardiovascular aging differences, impacting heart and blood vessel health.
Area of Science:
- Cardiovascular Science
- Aging Research
- Sex Differences in Medicine
Background:
- Cardiovascular disease (CVD) remains a leading cause of mortality.
- Cardiovascular aging involves changes in heart and blood vessels, including endothelial dysfunction and arterial stiffness.
- Biological sex significantly influences CVD incidence and progression, with distinct patterns observed between males and females.
Purpose of the Study:
- To review the molecular mechanisms underlying sex differences in cardiovascular aging.
- To elucidate how sex hormones impact blood pressure regulation and cardiac remodeling.
- To understand the loss of cardiovascular protection in women post-menopause.
Main Methods:
- Literature review focusing on molecular and cellular mechanisms.
- Analysis of studies investigating sex-specific cardiovascular pathophysiology.
- Synthesis of data on hormonal influences and autonomic function differences.
Main Results:
- Premenopausal women exhibit cardiovascular protection compared to men, attributed to factors like lower autonomic tone and better vascular function.
- Hypertension incidence is higher in men and increases in postmenopausal women.
- Arterial stiffness increases in postmenopausal women, exceeding that of age-matched men.
Conclusions:
- Sex hormones play a crucial role in blood pressure regulation and cardiovascular aging.
- Distinct molecular pathways contribute to sex-specific cardiovascular aging processes.
- Understanding these sex differences is vital for targeted CVD prevention and treatment strategies.
Abstract:
Cardiovascular disease (CVD) is still the leading cause of illness and death in the Western world. Cardiovascular aging is a progressive modification occurring in cardiac and vascular morphology and physiology where increased endothelial dysfunction and arterial stiffness are observed, generally accompanied by increased systolic blood pressure and augmented pulse pressure. The effects of biological sex on cardiovascular pathophysiology have long been known. The incidence of hypertension is higher in men, and it increases in postmenopausal women. Premenopausal women are protected from CVD compared with age-matched men and this protective effect is lost with menopause, suggesting that sex-hormones influence blood pressure regulation. In parallel, the heart progressively remodels over the course of life and the pattern of cardiac remodeling also differs between the sexes. Lower autonomic tone, reduced baroreceptor response, and greater vascular function are observed in premenopausal women than men of similar age. However, postmenopausal women have stiffer arteries than their male counterparts. The biological mechanisms responsible for sex-related differences observed in cardiovascular aging are being unraveled over the last several decades. This review focuses on molecular mechanisms underlying the sex-differences of CVD in aging.
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