title: Why sex matters: the biological mechanisms of cardiovascular disease.
abstract: Cardiovascular disease (CVD) is the leading determinant of mortality and morbidity in women. However, a full understanding of the basic and clinical aspects of CVD in women is far from being accomplished. Sexual dimorphism in CVD has been reported both in humans and experimental animals. Menopause is a risk factor for CVD due to the reduction of endogenous estrogen, although the mechanisms underlying are poorly understood. Estrogens act through binding to vascular estrogen receptors and by non-genomic mechanisms. Advances in this field are essential to improve CVD diagnostic and clinical strategies in women, and to develop sex-specific prevention plans as much as female-oriented treatment algorithms. This paper reviews pathophysiology of CVD in women and its potential clinical implications. Particular emphasis is given to biochemical markers and to indicators of cardiovascular dysfunction and damage. Estimation of these parameters, central to cardiovascular pathophysiology, could represent a particularly relevant tool in female patients. More research is needed to identify women who will profit most of early intervention.
authors.affiliation: G. Monasterio Foundation of the Toscana Region and Institute of Clinical Physiology-CNR, Pisa, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Vassalle
authors.forename: Tommaso
authors.initials: T
authors.lastname: Simoncini
authors.forename: Peter
authors.initials: P
authors.lastname: Chedraui
authors.forename: Faustino R
authors.initials: FR
authors.lastname: Pérez-López
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005260:Female; D012739:Gonadal Steroid Hormones / Q000378:metabolism*; D006801:Humans; D008297:Male; D008593:Menopause / Q000502:physiology; D012727:Sex Characteristics; D012737:Sex Factors
chemical_list: D012739:Gonadal Steroid Hormones