ABSTRACT
Cardiovascular disease (CVD) continues to be the primary cause of morbidity and mortality in the United States, but there are significant differences in how and when it is manifest in men compared to women. For example, the burden of hospitalization for acute myocardial infarction in younger patients aged 35–54 has increased over the past few decades, particularly in younger women, suggesting that understanding sex differences is essential to earlier diagnosis and treatment. Several reasons exist for the sex difference in CVD, particularly differential production, transportation, sensitivity, and detoxification of hormones. Additionally, there are sex differences in the rate of change of reproductive senescence, i.e., how rapidly a woman experiences a decline in estrogen and progesterone, or how rapidly a man experiences a decline in testosterone, as well as the changes in related hormones that accompany aging. Lastly, the influence of sex hormones on heart disease is a reflection of the significant role inflammation plays in coronary artery disease and the existence of differences in propensity to inflammatory conditions by gender.
