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Gender differences in acute aortic syndromes
Nitish Bhatt1, Jennifer Chia-Ying Chung2
1Faculty of Medicine, University of Toronto.
Current Opinion in Cardiology
|January 31, 2023
Summary
Acute aortic syndromes are more common in men. Women present later, face diagnostic delays, and experience higher early mortality and complications, highlighting critical sex-based differences in care.
Area of Science:
- Cardiovascular Medicine
- Aortic Disease Research
- Sex Differences in Health
Background:
- Acute aortic syndromes (AAS), encompassing acute aortic dissection, intramural hematoma, and penetrating aortic ulcer, are linked to significant mortality and morbidity.
- Understanding sex-related differences in AAS is crucial for improving patient outcomes.
- Recent advancements provide insights into the biological underpinnings of these disparities.
Approach:
- Review of large international and national registries.
- Analysis of population studies and multicentre prospective cohort studies.
- Examination of recent research on risk factors, aorta remodeling, and genetics.
Key Points:
- Acute aortic syndromes affect men more frequently than women.
- Women tend to present at an older age due to a sharper rise in risk factors with age.
- Delayed presentation and diagnosis, along with more conservative management for type A dissection in women, contribute to higher early mortality and complications.
Conclusions:
- Significant sex differences exist in the incidence, presentation, and outcomes of acute aortic syndromes.
- Biological and potentially socioeconomic factors contribute to these disparities.
- Updated guidelines may influence management and outcomes, necessitating continued research into sex-specific care for AAS.
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