Sex Differences: Potential Impact in Vascular Physiopathology or Ischemic Heart Disease

Pathophysiological mechanisms for development and progression of ischemic heart disease, which is essentially an age-related condition, may differ between men and women. Age-related changes in cardiac and vascular anatomy and physiopathology combined with traditional risk factors affect the likelihood of developing heart disease. Sex specific features of cardiac and vascular remodeling with age are associated with a higher prevalence of ischemic heart disease in women post-menopause. Cardiac symptoms such as chest pain/discomfort are often less in women, which generally results in less aggressive clinical treatment compared to men. Incidentally, treatment guidelines for acute myocardial infarction have for the most part, been established from studies with a large male cohort. Sex differences relating to effects of ischemia on overall cardiovascular function could contribute to worse clinical outcomes for females. Treatment options for women also arise because they generally present with multiple co-morbidities. The present review focuses on recent findings for sex differences in pathogenesis of ischemic heart disease, vascular function as well as potential use of cardio protection strategies.