Female-specific aspects in the pharmacotherapy of chronic cardiovascular diseases.
Differences in pharmacokinetics, pharmacodynamics, and physiology contribute to the phenomenon that women and men frequently respond differently to cardiovascular drugs. Hormonal influences, in addition, can play an important role: for example, the menstrual cycle, menopause, and pregnancy--as a result of fluctuations in concentrations of sexual steroids, and of changes in total body water--can be associated with gender-specific differences in the plasma levels of cardiovascular drugs. Clinical relevance accordingly results, especially for substances with a narrow therapeutic margin. This review treats the most important pharmacodynamic gender-relevant differences in this context, and surveys available evidence on the benefits of therapy of chronic cardiovascular diseases in women. On the whole, the study situation for women is appreciably less favourable than for men: owing to the fact that women are under-represented in most studies, and that few gender-specific analyses have been conducted.
Jochmann
Nicoline
N
Medizinische Klinik mit Schwerpunkt Kardiologie, Angiologie, Pneumologie, Institut für Klinische Pharmakologie, Universitätsmedizin Berlin, D-10117 Berlin, Germany.
Stangl
Karl
K
Garbe
Edeltraut
E
Baumann
Gert
G
Stangl
Verena
V
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D002908:Chronic Disease; D000077144:Clopidogrel; D004071:Digitalis Glycosides / Q000627:therapeutic use; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D012737:Sex Factors; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016387:Women's Health
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000889:Anti-Arrhythmia Agents; D002121:Calcium Channel Blockers; D002317:Cardiovascular Agents; D004071:Digitalis Glycosides; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin