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Mechanistic Pathways of Sex Differences in Cardiovascular Disease
Abstract
Major differences between men and women exist in epidemiology, manifestation, pathophysiology, treatment, and outcome of cardiovascular diseases (CVD), such as coronary artery disease, pressure overload, hypertension, cardiomyopathy, and heart failure. Corresponding sex differences have been studied in a number of animal models, and mechanistic investigations have been undertaken to analyze the observed sex differences. We summarize the biological mechanisms of sex differences in CVD focusing on three main areas, i.e., genetic mechanisms, epigenetic mechanisms, as well as sex hormones and their receptors. We discuss relevant subtypes of sex hormone receptors, as well as genomic and nongenomic, activational and organizational effects of sex hormones. We describe the interaction of sex hormones with intracellular signaling relevant for cardiovascular cells and the cardiovascular system. Sex, sex hormones, and their receptors may affect a number of cellular processes by their synergistic action on multiple targets. We discuss in detail sex differences in organelle function and in biological processes. We conclude that there is a need for a more detailed understanding of sex differences and their underlying mechanisms, which holds the potential to design new drugs that target sex-specific cardiovascular mechanisms and affect phenotypes. The comparison of both sexes may lead to the identification of protective or maladaptive mechanisms in one sex that could serve as a novel therapeutic target in one sex or in both.
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Pressure overload and neurohumoral activation differentially affect the myocardial proteome
Schott, P., Singer, S. S., Kögler, H., Neddermeier, D., Leineweber, K., Brodde, O., Regitz‐Zagrosek, V., Schmidt, B., Dihazi, H., & Hasenfuss, G. P. (2005) · PROTEOMICS · doi:10.1002/pmic.200401005 · Cited by 40
Self-citationSex-biased chromatin and regulatory cross-talk between sex chromosomes, autosomes, and mitochondria
Silkaitis, K., & Lemos, B. (2014) · Biology of Sex Differences · doi:10.1186/2042-6410-5-2 · Cited by 39 · cited 1×
“They have been postulated to contribute to sex-specific susceptibilities to autoimmune and neurological diseases (361).”
BackgroundEpigenetics and the Estrogen Receptor
Leader, J. E., Wang, C., Popov, V. M., Fu, M., & Pestell, R. G. (2006) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1386.047 · Cited by 39
MacDonald, J. K., Pyle, W. G., Reitz, C. J., & Howlett, S. E. (2014) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00730.2013 · Cited by 39
Wang, Y., Wang, Q., Zhao, Y., Gong, D., Wang, D., Li, C., & Zhao, H. (2010) · Circulation Journal · doi:10.1253/circj.cj-09-0223 · Cited by 38
Puzianowska‐Kuźnicka, M. (2011) · Clinica Chimica Acta · doi:10.1016/j.cca.2011.10.028 · Cited by 38
Kararigas, G., Nguyen, B. T., Zelarayan, L. C., Hassenpflug, M., Toischer, K., Sanchez‐Ruderisch, H., Hasenfuss, G. P., Bergmann, M., Jarry, H., & Regitz‐Zagrosek, V. (2014) · Endocrinology · doi:10.1210/en.2013-2180 · Cited by 36
Self-citationEstrogen Receptor Molecular Biology
Brown, M. A. (1994) · Hematology/Oncology Clinics of North America · doi:10.1016/s0889-8588(18)30189-8 · Cited by 36
Cited by
Sex and gender: modifiers of health, disease, and medicine
Mauvais-Jarvis, F., Bairey Merz, N., Barnes, P. J., Brinton, R. D., Carrero, J.-J., DeMeo, D. L., De Vries, G. J., Epperson, C. N., Govindan, R., Klein, S. L., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)31561-0 · Cited by 2,001
Self-citationSex differences in pharmacokinetics predict adverse drug reactions in women
Zucker, I., & Prendergast, B. J. (2020) · Biology of Sex Differences · doi:10.1186/s13293-020-00308-5 · Cited by 777
Schultheiss, H.-P., Fairweather, D., Caforio, A. L. P., Escher, F., Hershberger, R. E., Lipshultz, S. E., Liu, P. P., Matsumori, A., Mazzanti, A., McMurray, J., et al. (2019) · Nature Reviews Disease Primers · doi:10.1038/s41572-019-0084-1 · Cited by 720
Cooke, P. S., Nanjappa, M. K., Ko, C., Prins, G. S., & Hess, R. A. (2017) · Physiological Reviews · doi:10.1152/physrev.00018.2016 · Cited by 466
The hematologic consequences of obesity
Purdy, J. C., & Shatzel, J. J. (2021) · European Journal Of Haematology · doi:10.1111/ejh.13560 · Cited by 227
Metadata
- Authors
- Regitz-Zagrosek, V., & Kararigas, G.
- Venue
- Physiological Reviews
- Publisher
- American Physiological Society
- Published
- 2017-01
- Volume
- 97
- Issue
- 1
- Pages
- 1-37
- ISSN
- 0031-9333 (ISSN-L)
- 1522-1210
- OpenAlex
- W2548440622
- Cited by
- 732
- References
- 433
- FWCI
- 7.74
- Type
- journal article
- Language
- en
- Open access
- closed
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.