http://atvb.ahajournals.org/content/38/1/9?etoc=
This article requires a subscription to view the full text. If
you have a subscription you may use the login form below to view the
article. Access to this article can also be purchased.
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 …
No comments:
Post a Comment