X Marks the Spot The Profound Impact of Sex on Aortic Disease

Damn, I thought this would talk about the preventative benefits of sex that you could bring to your doctor and ask how it would be accommodated in the hospital.
http://atvb.ahajournals.org/content/38/1/9?etoc=

Siddharth K. Prakash, Dianna M. Milewicz

https://doi.org/10.1161/ATVBAHA.117.310433

Arteriosclerosis, Thrombosis, and Vascular Biology. 2018;38:9-11

Originally published December 27, 2017

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Biological sex and gender exert profound effects on all aspects of cardiovascular disease, from susceptibility to disease to therapeutic outcomes to access to care. Women typically develop coronary heart disease when they are older than men but experience disproportionate harm from risk factors, such as smoking and diabetes mellitus, and have a higher mortality after myocardial infarction.^1,2 Similar sex differences are observed for both thoracic and abdominal aortic aneurysms (AAAs). Male sex is the most potent nonmodifiable risk factor for AAAs, with estimates ranging from a 4- to 10-fold higher incidence in men than in women.^3,4

See accompanying article on page 143

Thoracic aortic aneurysms and acute aortic dissections also primarily affect men but to a lesser extent than AAA. Individuals presenting for surgical repair of either a thoracic aneurysm or acute dissection are 65% men.⁵ Similarly, the International Registry of Acute Aortic Dissection reported a male predominance of 65% among individuals presenting with an acute aortic dissection.⁶ Furthermore, individuals with a single autosomal gene mutation predisposing them to thoracic aortic aneurysms are predominantly men. Recent data on the largest cohort to date of patients with Marfan syndrome in the National Registry of Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions demonstrate that male sex is associated with more severe and earlier symptoms.^7–9 The age of onset of aortic events was even more dramatically different based on sex in patients with TGFBR1(TGF-β [transforming growth factor-β] receptor type 1) mutations, with 90% of men having an event by age of 60 years compared with only half the women.¹⁰ The proportion of men presenting with aortic dissections is also higher than women. In contrast, there is no dramatic difference based …

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