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Updated: Jun 14, 2025
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Published on: May 26, 2023
Sex Differences in Cardiovascular Diseases: Exploring the Role of Microbiota and Immunity
Laura Franza1,2, Mario Caldarelli3,4, Emanuele Rocco Villani5,6
1Emergency, Anesthesiological and Reanimation Sciences Department, Fondazione Policlinico Universitario A. Gemelli-IRCCS of Rome, 00168 Rome, Italy.
Insights
Cardiovascular diseases (CVDs) exhibit sex-specific patterns, potentially mediated by gut microbiota (GM) differences. This review explores the interplay between sex, GM, and CVDs for therapeutic insights.
Area of Science:
- Cardiology
- Microbiology
- Endocrinology
Background:
- Cardiovascular diseases (CVDs) are a leading cause of death globally, with distinct prevalence and presentation in males and females.
- Sex hormones and the gut microbiota (GM) are implicated in CVDs, with GM composition differing between sexes.
- Gut-derived metabolites are linked to CVDs and kidney disorders, potentially influencing CVD progression.
Purpose of the Study:
- To comprehensively review the complex interplay between sex, gut microbiota, and cardiovascular diseases.
- To discuss potential mechanisms underlying sex disparities in CVDs influenced by the gut microbiota.
- To explore emerging therapeutic strategies targeting the gut microbiota for CVD management.
Main Methods:
- This study is a narrative review.
- Literature search focused on the relationship between sex, gut microbiota, and cardiovascular diseases.
- Analysis of existing research on sex hormones, gut microbiota composition, and their impact on CVDs.
Main Results:
- Evidence suggests significant differences in gut microbiota composition between males and females.
- Gut microbiota and their metabolites may act as mediators in the sex-specific disparities observed in CVDs.
- Sex hormones influence gut microbiota, contributing to sex differences in cardiovascular health.
Conclusions:
- The gut microbiota plays a crucial role in cardiovascular health and may mediate sex differences in CVDs.
- Understanding the sex-gut microbiota-CVD axis is vital for developing targeted therapeutic interventions.
- Future research should focus on sex-specific modulation of the gut microbiota to prevent and treat cardiovascular diseases.
Abstract:
Cardiovascular diseases (CVDs) are the most common cause of mortality and morbidity in Western countries, thus representing a global health concern. CVDs show different patterns in terms of the prevalence and presentation in men and women. The role of sex hormones has been extensively implicated in these sex-specific differences, due to the presence of the menstrual cycle and menopause in women. Moreover, the gut microbiota (GM) has been implicated in cardiovascular health, considering the growing evidence that it is involved in determining the development of specific diseases. In particular, gut-derived metabolites have been linked to CVDs and kidney disorders, which can in turn promote the progression of CVDs. Considering the differences in the composition of GM between men and women, it is possible that gut microbiota act as a mediator in regard to the sex disparities in CVDs. This narrative review aims to comprehensively review the interplay between sex, GM, and CVDs, discussing potential mechanisms and therapeutic options.
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