Sex and Gender Differences in Cardiovascular Diseases

Cardiovascular diseases have such a devastating and increasing impact on the entire world population. In the last decade, sex differences have been found in the epidemiology, pathophysiology, treatment, and resolution of these pathologies. Therefore, research is focused on improving the knowledge of the mechanisms underlying these discrepancies. In this minireview we summarize some of the main processes that are involved in the development of cardiovascular diseases, pointing out the major differences between male and female. We discuss disparities in the exposure to risk factors, in the electrophysiology of the heart, and in the maintenance of contractile functions by Ca regulation. In addition, due to the importance of sexual hormones in the regulation of metabolism and maintenance of cardiac function, the role of estrogen on different parameters has been analyzed. We focus on endothelial factors and NOD-, LRR, and pyrin domaincontaining 3 protein (NLRP3) modulation by estrogen. In conclusion, many molecular factors and cellular mechanisms that result in cardiovascular disease are different in men and women. Therefore, further research is necessary to enhance the understanding of all the sex related differences.