Understanding the Role of Sex in Heart Valve and Major Vascular Diseases.

Cardiovascular disease (CVD) is the major cause of mortality in the elderly population. The cost of CVD treatment and surgeries was over $300 billion in the United States alone in 2010, making this disorder a critical healthcare issue. Many studies have suggested sex as a risk factor for heart valve and major vascular diseases, such as aortic valve stenosis, mitral prolapse and regurgitation, atherosclerosis, coronary artery disease, and abdominal aortic aneurysm. Unfortunately, only a handful of studies have illustrated the role of sex in the etiology and progression of these disorders. Moreover, knowledge of biomolecular factors that affect these diseases in men and women is very limited. Numerous clinical studies have revealed obvious differences in the prevalence of these diseases between the sexes. These reports were supported by a few molecular and cellular physiology studies that associated this difference to sex and sex hormones. In particular, male sex has commonly been identified as a risk factor for majority of heart valve and vascular diseases, whereas females have been identified as higher risk for certain disorders as well. In addition, menopause is a critical issue that turns the tables against women and enhances complications in their cardiovascular structure due to hormonal change. In this review, major vascular and heart valve diseases for which sex is associated as a risk factor have been reviewed to highlight the importance of this risk factor in CVDs.