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Updated: Jan 9, 2026

Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test
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Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test

Published on: April 27, 2016

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Endothelial Dysfunction in Sex-Specific Disparities in Cardiovascular Diseases: Biological Mechanisms,

Canran Lv1,2,3,4, Chu Chen1,2,3,4, Cuiyuan Huang2,3,4

  • 1Department of Cardiology, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital Yichang, 443000 Yichang, Hubei, China.

Reviews in Cardiovascular Medicine
|December 8, 2025
PubMed

Insights

Cardiovascular disease (CVD) outcomes differ by sex due to endothelial dysfunction. This study links molecular insights to therapies, sex-adjusted diagnostics, and trial reforms for precision cardiology.

Area of Science:

  • Cardiovascular research
  • Endocrinology
  • Precision medicine

Background:

  • Sex-specific disparities exist in cardiovascular disease (CVD) pathogenesis and outcomes.
  • Endothelial dysfunction is a key mediator of sex differences in CVD.
  • Estrogen offers cardioprotection, while androgens can promote inflammation and oxidative stress.

Purpose of the Study:

  • To bridge molecular insights with translational strategies for CVD.
  • To propose endothelial-targeted therapies and sex-adjusted diagnostic algorithms.
  • To advocate for policy-driven reforms in clinical trials for precision cardiology.

Main Methods:

  • Review of molecular mechanisms underlying sex-specific endothelial dysfunction.
  • Analysis of clinical presentations and diagnostic challenges in men versus women.
  • Synthesis of translational approaches for sex-specific CVD management.

Main Results:

  • Men typically develop obstructive coronary disease, while women often present with microvascular ischemia.
  • Sex-specific risk factors and treatment disparities persist in CVD.
  • Estrogen's protective role contrasts with androgens' dual pathological effects.

Conclusions:

  • Prioritizing endothelial-sex hormone crosstalk is crucial for understanding CVD pathophysiology.
  • Sex-stratified diagnostics and therapeutics are needed to advance precision cardiology.
  • Reforming clinical trials is essential to address sex-based gaps in CVD care.

Keywords:
cardiovascular diseaseendothelial dysfunctionsex hormonesex-specific disparitytranslational medicine strategies

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