Divergent mechanisms of cardiovascular remodeling between men and women

Area of Science:

• Cardiovascular Medicine
• Sex Differences in Biology
• Molecular Cardiology

Background:

• Cardiovascular diseases (CVD) are a leading cause of death globally.
• Significant sex-based disparities exist in CVD manifestation, progression, outcomes, and treatment response.
• Premenopausal women exhibit cardioprotection, which diminishes post-menopause, implicating sex hormones like estrogen.

Purpose of the Study:

• To elucidate biological sex-specific pathways influencing cardiovascular diseases.
• To explore how sex influences the renin-angiotensin-aldosterone system, oxidative stress, inflammation, endothelial function, microRNA regulation, and cell death.
• To advocate for sex- and gender-informed approaches in cardiovascular care.

Main Methods:

• Review and elucidation of existing literature on sex-biased mechanisms in CVD.
• Analysis of pathways including the renin-angiotensin-aldosterone system, oxidative stress, inflammation, endothelial function, microRNA regulation, and cell death.
• Focus on biological sex differences rather than gender.

Main Results:

• Biological sex significantly modulates key cardiovascular pathways.
• Differences in renin-angiotensin-aldosterone system activity, oxidative stress responses, inflammation, endothelial function, microRNA regulation, and cell death contribute to sex-biased CVD progression.
• Estrogen's protective role is suggested but requires further investigation within a sex-specific context.

Conclusions:

• More research into sex-biased mechanisms is essential for advancing cardiovascular disease understanding.
• Developing sex- and gender-informed guidelines is critical for equitable and effective cardiovascular care.
• Addressing sex differences in CVD can lead to improved patient outcomes and personalized treatment strategies.