A comprehensive view of sex-specific issues related to cardiovascular disease.
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.
Pilote
Louise
L
Division of Internal Medicine, The McGill University Health Centre Research Institute, McGill University, Montréal, Que. louise.pilote@mcgill.ca
Dasgupta
Kaberi
K
Guru
Veena
V
Humphries
Karin H
KH
McGrath
Jennifer
J
Norris
Colleen
C
Rabi
Doreen
D
Tremblay
Johanne
J
Alamian
Arsham
A
Barnett
Tracie
T
Cox
Jafna
J
Ghali
William Amin
WA
Grace
Sherry
S
Hamet
Pavel
P
Ho
Teresa
T
Kirkland
Susan
S
Lambert
Marie
M
Libersan
Danielle
D
O'Loughlin
Jennifer
J
Paradis
Gilles
G
Petrovich
Milan
M
Tagalakis
Vicky
V
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