Heart Disease Differences in Men and Women

Heart Disease Differences in Men and Women

of the strongest and most well-characterized sex
differences that we have in the biomedical
sciences is in terms of heart disease, in which the
onset of cardiovascular disease is about 10 years later for
women than it is for men. And this seems to correspond
with the onset of menopause, suggesting that
lower estrogen may correspond with an
increased risk for heart disease in women. Other examples that are
quite well-pronounced pertain to some of the
events that occur just before a heart attack. So coronary thrombosis presents
itself quite differently in men than women. So in men, you have the
textbook rupture of a plaque. It’s a very fast,
aggressive change in the artery that’s
going to result in a reduction or no blood
flow preceding a heart attack. And that really is the textbook
case for coronary thrombosis. And it turns out that
a majority of women present very differently. They present with a slower,
more superficial plaque erosion. And in being slower, it often is
missed or goes underdiagnosed. And so what was once considered
the classic or normal case for a heart attack,
we’re really starting to understand is just
the man’s heart attack. Women are presenting
differently. Heart disease is not
the only manifestation of sex-based biology. One mechanism that clearly
differs between men and women is inflammation, with
females typically showing a much higher
inflammatory response than men, which may
underlie heart disease. It also contributes to responses
to infectious diseases, which is what I study
in my laboratory. And data from my
laboratory illustrate that females consistently
mount much higher inflammatory immune
responses, which can be very beneficial for
clearing a viral infection, for example. But it can also be
detrimental, contributing to the development of
autoimmune disease, also contributing
to what’s referred to as immune-mediated pathology,
in which our responses become too high and contribute
to damage to tissue. So much of the work
in my laboratory is trying to better
understand the cost and benefits of these heightened
inflammatory responses in females.

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