title: A comprehensive view of sex-specific issues related to cardiovascular disease.
abstract: Cardiovascular disease (CVD) is the leading cause of mortality in women. In fact, CVD is responsible for a third of all deaths of women worldwide and half of all deaths of women over 50 years of age in developing countries. The prevalence of CVD risk factor precursors is increasing in children. Retrospective analyses suggest that there are some clinically relevant differences between women and men in terms of prevalence, presentation, management and outcomes of the disease, but little is known about why CVD affects women and men differently. For instance, women with diabetes have a significantly higher CVD mortality rate than men with diabetes. Similarly, women with atrial fibrillation are at greater risk of stroke than men with atrial fibrillation. Historically, women have been underrepresented in clinical trials. The lack of good trial evidence concerning sex-specific outcomes has led to assumptions about CVD treatment in women, which in turn may have resulted in inadequate diagnoses and suboptimal management, greatly affecting outcomes. This knowledge gap may also explain why cardiovascular health in women is not improving as fast as that of men. Over the last decades, mortality rates in men have steadily declined, while those in women remained stable. It is also becoming increasingly evident that gender differences in cultural, behavioural, psychosocial and socioeconomic status are responsible, to various degrees, for the observed differences between women and men. However, the interaction between sex-and gender-related factors and CVD outcomes in women remains largely unknown.
authors.affiliation: Division of Internal Medicine, The McGill University Health Centre Research Institute, McGill University, Montréal, Que. louise.pilote@mcgill.ca
authors.forename: Louise
authors.initials: L
authors.lastname: Pilote
authors.forename: Kaberi
authors.initials: K
authors.lastname: Dasgupta
authors.forename: Veena
authors.initials: V
authors.lastname: Guru
authors.forename: Karin H
authors.initials: KH
authors.lastname: Humphries
authors.forename: Jennifer
authors.initials: J
authors.lastname: McGrath
authors.forename: Colleen
authors.initials: C
authors.lastname: Norris
authors.forename: Doreen
authors.initials: D
authors.lastname: Rabi
authors.forename: Johanne
authors.initials: J
authors.lastname: Tremblay
authors.forename: Arsham
authors.initials: A
authors.lastname: Alamian
authors.forename: Tracie
authors.initials: T
authors.lastname: Barnett
authors.forename: Jafna
authors.initials: J
authors.lastname: Cox
authors.forename: William Amin
authors.initials: WA
authors.lastname: Ghali
authors.forename: Sherry
authors.initials: S
authors.lastname: Grace
authors.forename: Pavel
authors.initials: P
authors.lastname: Hamet
authors.forename: Teresa
authors.initials: T
authors.lastname: Ho
authors.forename: Susan
authors.initials: S
authors.lastname: Kirkland
authors.forename: Marie
authors.initials: M
authors.lastname: Lambert
authors.forename: Danielle
authors.initials: D
authors.lastname: Libersan
authors.forename: Jennifer
authors.initials: J
authors.lastname: O'Loughlin
authors.forename: Gilles
authors.initials: G
authors.lastname: Paradis
authors.forename: Milan
authors.initials: M
authors.lastname: Petrovich
authors.forename: Vicky
authors.initials: V
authors.lastname: Tagalakis
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D002423:Cause of Death; D002648:Child; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D012737:Sex Factors; D016019:Survival Analysis