Sex and gender are important modifiers of cardiovascular system physiology, pathophysiology,
and disease development. The atherosclerosis process, together with the progressive
loss of arterial elasticity with age, is a major factor influencing the development
of overt cardiovascular, renal, and cerebrovascular disease. While differences between
women and men in epidemiology and pathophysiology of vascular ageing are increasingly
reported, sex-disaggregated data are still scarcely available for prospective studies.
A better knowledge of sex differences in physiological ageing as well as in disease-related
changes in vascular ageing trajectories is crucial to avoid misdiagnosis and mistreatment.
This review presents key concepts and knowledge gaps identified in vascular ageing
due to gonadal function, vascular physiology, pathophysiology, psychosocial factors,
pregnancy, and prognostic relevance. Gender roles determine the effectiveness of any
cardiovascular preventive strategy and acceptance for non-invasive or invasive diagnostics
and therapeutics. Gender differences in health behaviour, also due to sociocultural
norms conditioned by society, contribute to behaviours that may lead to premature
arterial vascular ageing. These include differences in risk behaviours like smoking,
diet, exercise, and in stress, but also conditions such as housing, noise pollution,
poverty, disability, and any kind of stigmatisation.
The VascAgeNet Gender Expert Group aims to advance the use of non-invasive vascular
ageing measures in routine clinical settings by providing facts to fill in the gaps
concerning sex and gender differences at each step of this process, and to search
for solutions.
Keywords
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Article info
Publication history
Published online: August 25, 2021
Accepted:
July 12,
2021
Received in revised form:
July 9,
2021
Received:
March 28,
2021
Footnotes
This paper is based upon work from the European COST ACTION-Network for Research in Vascular Ageing CA18216 supported by COST, European Union (European Cooperation in Science and Technology, European Union) and endorsed by the German Society of Gender Medicine (DGesGM).
Identification
Copyright
© 2021 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
