The importance of gender to understand sex differences in cardiovascular disease

Connelly, P. J. , Azizi, Z., Alipour, P., Delles, C. , Pilote, L. and Raparelli, V. (2021) The importance of gender to understand sex differences in cardiovascular disease. Canadian Journal of Cardiology, 37(5), pp. 699-710. (doi: 10.1016/j.cjca.2021.02.005) (PMID:33592281)

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Abstract

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide. There is robust evidence of heterogeneity in underlying mechanism, manifestation, prognosis and response to treatment of CVD between males and females. Gender, which refers to the socially constructed roles, behaviors, expressions, and identities of individuals, is an important determinant of cardiovascular health and its consideration might help for a broader understanding of the observed sex differences in CVD. Established risk factors such as hypertension, dyslipidemia, diabetes mellitus, obesity and smoking are well known to contribute to CVD. However, despite the differences in CVD risk between males and females, most studies looking into the magnitude of effect of each risk factor have traditionally focused on males. While biological sex influences disease pathophysiology, the psycho-socio-cultural construct of gender can further interact with this effect. Behavioural, psychosocial, personal, cultural and societal factors can create, repress, or strengthen underlying biological CV health differences. Although mechanisms of action are largely unclear, it is suggested that gender related factors can further exacerbate the detrimental effect of established risk factors of CVD. In this narrative review we explore the current literature investigating the role of gender in CV risk and its impact upon established risk factors as a fundamental step toward precision medicine.

Item Type:Articles
Additional Information:PJC and CD are supported by supported by the British Heart Foundation (Centre of Research Excellence Awards RE/13/ 5/30177 and RE/18/6/34217). ZA is the post-doctoral fellow and LP principal investigator of the GOING-FWD (Gender Outcomes INternational Group: to Further Well-being Development) Consortium that is funded by the GENDER-NET Plus ERA-NET Initiative (Project Ref. Number: GNP-78): The Canadian Institutes of Health Research (GNP-161904), "La Caixa" Foundation (ID 100010434) with code LCF/PR/DE18/52010001, The Swedish Research Council (2018-00932) and The Austrian Science Fund (FWF, I 4209). LP holds a James McGill chair at McGill University. VR is the co-principal investigator of the GOING-FWD Consortium and was funded by the Scientific Independence of Young Researcher Program of the Italian Ministry of University, Education, and Research (RBSI14HNVT).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Delles, Professor Christian and Connelly, Dr Paul
Authors: Connelly, P. J., Azizi, Z., Alipour, P., Delles, C., Pilote, L., and Raparelli, V.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Canadian Journal of Cardiology
Publisher:Elsevier
ISSN:0828-282X
ISSN (Online):1916-7075
Published Online:13 February 2021
Copyright Holders:Copyright © 2021 Elsevier Inc. on behalf of the Canadian Cardiovascular Society
First Published:First published in Canadian Journal of Cardiology 37(5): 699-710
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
303944BHF Centre of ExcellenceRhian TouyzBritish Heart Foundation (BHF)RE/18/6/34217CAMS - Cardiovascular Science
190814BHF centre of excellenceRhian TouyzBritish Heart Foundation (BHF)RE/13/5/30177Institute of Cardiovascular & Medical Sciences