Coronary microvascular dysfunction in menopausal women

Area of Science:

• Cardiology
• Women's Health
• Vascular Biology

Background:

• Cardiovascular disease (CVD) is the leading global cause of death.
• Coronary microvascular dysfunction (CMD) is increasingly recognized in menopausal women, contributing to chronic coronary syndrome (CCS).
• Hormonal shifts and metabolic changes during menopause accelerate vascular aging and endothelial dysfunction in women.

Purpose of the Study:

• Highlight research gaps in understanding the sex-specific pathophysiology of CMD in menopausal women.
• Emphasize the need for tailored diagnostic and treatment strategies for women with CMD.
• Advocate for sex-specific research to improve risk stratification and prognosis in this cohort.

Main Methods:

• Review of existing literature on CMD, menopause, and cardiovascular disease in women.
• Analysis of prevalence and risk factors for CMD in menopausal women.
• Examination of sex differences in CMD pathophysiology and clinical presentation.

Main Results:

• CMD is more prevalent in women than men, associated with higher risks of adverse cardiovascular events and mortality.
• Menopausal women with CMD are frequently diagnosed with Takotsubo syndrome and heart failure with preserved ejection fraction (HFpEF).
• Current clinical guidelines often rely on male-dominant data, leading to potential misdiagnosis and suboptimal treatment for women.

Conclusions:

• Significant knowledge gaps exist regarding the sex-specific mechanisms of CMD in menopausal women.
• Current diagnostic and treatment approaches may not adequately address sex differences, impacting women's prognosis.
• Further sex-specific research is essential to achieve health equity and reduce the burden of CVD in menopausal women.