Sex-Specific Differences in Subclinical Organ Damage and Cardiovascular Risk Stratification Among Patients Classified by the Presence of Coronary Artery Disease and Hypertension

Cardiovascular diseases are the leading cause of death. Women are more frequently affected by these diseases than men.

To investigate the relationships between subclinical organ damage markers: ankle-brachial index (ABI), pulse wave velocity (PWV), intima-media thickness (IMT) and cardiovascular risk assessed by SCORE2/SCORE2-OP scales, stratified by sex and the presence or absence of coronary artery disease (CAD) and/or hypertension (HT).

We studied 200 patients divided into groups: CAD + HT+, CAD + HT-, CAD-HT+, and CAD-HT-. Measurements included: ABI, PWV, IMT and cardiovascular risk assessed by SCORE2/SCORE2-OP scales. Statistical analyses were performed using StatSoft Statistica 10.

In hypertensive and non-hypertensive groups, cardiovascular risk assessed by SCORE2/SCORE2-OP scales was higher in men than in women. In the group without CAD, women- with and without hypertension- showed a significant correlation between cardiovascular risk and both ABI and IMT. In men without CAD and hypertension, cardiovascular risk correlated significantly with PWV and IMT. In logistic regression models within the primary prevention group (with or without hypertension), significant correlations between ABI and SCORE2/SCORE2-OP were observed only in women, whereas significant correlations between PWV and SCORE2/SCORE2-OP were found only in men.

Sex-related differences in cardiovascular risk factor profiles and disease progression highlight the importance of sex-specific approaches in risk stratification and management. Logistic regression models suggest a dependence on patient sex in predictive accuracy and biomarker significance. These findings point to a potential role for sex-specific models in risk assessment, but must be interpreted cautiously as associative, not predictive, consistent with the observational design.