Pulmonary Arterial Hypertension and the Sex Hormone Paradox.
OBJECTIVE
Prevalence and outcome differences between women and men with pulmonary arterial hypertension (PAH) raise questions about the role of sex hormones in disease pathobiology. This review will summarize the current understanding of sex and sex hormone pathways and their influence on heart-lung function in health and in disease.


RESULTS
Female sex has been shown to be a risk factor for the development of PAH, but women have improved survival compared to men with PAH. These paradoxical observations are likely driven in part by complex sex hormone signaling and processing pathways and their interaction with the pulmonary vasculature and the right ventricle. These relationships may vary depending on an individual's underlying sex, age, and/or genetic substrate. The study of the connections between sex, sex hormones, the pulmonary circulation, and the right ventricle may improve our understanding of disease epidemiology and outcomes and lead to new treatment strategies for PAH.
Division of Pulmonary, Critical Care and Sleep, Brown University, Providence, RI, USA.|Department of Medicine, Brown University, Providence, RI, USA.
Andrew
A
Foderaro
Division of Pulmonary, Critical Care and Sleep, Brown University, Providence, RI, USA. corey_ventetuolo@brown.edu.|Department of Medicine, Brown University, Providence, RI, USA. corey_ventetuolo@brown.edu.|Health Services, Policy, and Practice, Brown University, Providence, RI, USA. corey_ventetuolo@brown.edu.
Corey E
CE
Ventetuolo
D000818:Animals; D012739:Gonadal Steroid Hormones / Q000378:metabolism*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000378:metabolism* / Q000503:physiopathology; D008168:Lung / Q000098:blood supply; D012307:Risk Factors; D012727:Sex Characteristics
D012739:Gonadal Steroid Hormones
Estrogen paradox; Pulmonary hypertension; Right ventricle; Sex hormones