title: Gender differences in cardiovascular prophylaxis: Focus on antiplatelet treatment.
abstract: Cardiovascular disease (CVD) represents the leading cause of death worldwide, and equally affects both sexes although women develop disease at an older age than men. A number of clinical evidence has identified the female sex as an independent factor for poor prognosis, with the rate of mortality and disability following an acute cardiovascular (CV) event being higher in women than men. It has been argued that the different level of platelet reactivity between sexes may account for a different responsiveness to anti-platelet therapy, with consequent important implications on clinical outcomes. However, conclusive evidence supporting the concept of a gender-dependent effectiveness of platelet inhibitors are lacking. On the contrary, sex-related dissimilarities have been evidenced in cardiovascular patients in terms of age of presentation, comorbidities such as obesity, diabetes and renal disease, and a different pharmacological approach to and effectiveness in controlling classical cardiovascular risk factors such as hypertension, glucose profile and lipid dysmetabolism. All these factors could place women at an increased level of cardiovascular risk compared to men, and may concur to an enhanced pro-thrombogenic profile. The purpose of this manuscript is to provide an overview of gender-related differences in cardiovascular treatment, in order to highlight the need to improve the pharmacological prophylaxis adopted in women through a more accurate evaluation of the overall cardiovascular risk profile with consequent establishment of a more effective and targeted anti-thrombotic strategy which is not limited to the use of anti-platelet agents.
authors.affiliation: Department of Life, Health & Environmental Sciences, University of L'Aquila, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Di Giosia
authors.affiliation: Department of Clinical Pharmacology, Cardiovascular Division, British Heart Foundation Centre for Research Excellence, King's College London, London, UK.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Passacquale
authors.affiliation: Department of Life, Health & Environmental Sciences, University of L'Aquila, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Petrarca
authors.affiliation: Department of Life, Health & Environmental Sciences, University of L'Aquila, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Giorgini
authors.affiliation: IRCCS SND, Via E. Gianturco 113, Naples, Italy.
authors.forename: Alberto Maria
authors.initials: AM
authors.lastname: Marra
authors.affiliation: Department of Clinical Pharmacology, Cardiovascular Division, British Heart Foundation Centre for Research Excellence, King's College London, London, UK. Electronic address: albert.ferro@kcl.ac.uk.
authors.forename: Albert
authors.initials: A
authors.lastname: Ferro
mesh_terms: D001792:Blood Platelets / Q000187:drug effects* / Q000473:pathology; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D011379:Prognosis; D012727:Sex Characteristics; D012737:Sex Factors
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Antiplatelet treatment; Cardiovascular disease; Gender; Platelet