Sex Differences in Myocardial and Vascular Aging.
Sex Differences in Myocardial and Vascular Aging.
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DOI：
10.1161/circresaha.121.319902
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发表时间：
2022-02-18
影响因子：
20.1
通讯作者：
Cheng S
中科院分区：
文献类型：
--
作者：
Ji H;Kwan AC;Chen MT;Ouyang D;Ebinger JE;Bell SP;Niiranen TJ;Bello NA;Cheng S
众所周知，心血管疾病（CVD）在女性和男性中表现不同。这些差异的根本原因在衰老的寿命是不太好理解。心脏和血管表型的性别差异见于儿童时期，并且倾向于沿着与遗传因素的二态性以及对风险暴露的反应和生命过程中的激素变化相关的沿着不同的轨迹。这些差异是日后心血管事件（包括心肌梗死、心力衰竭、缺血性中风和外周血管疾病）性别特异性差异的基础。关于心脏表型，女性具有固有的较小的身体尺寸调整的心脏体积，然后往往会经历更大的年龄相关的壁增厚和心肌硬化随着年龄的增长。在血管表型方面，生理学和病理生理学上的两性异形也被发现，包括血压轨迹的明显差异。随着年龄的增长，心肌和血管改变的性别差异似乎从生命的早期到晚期都遵循相对一致的轨迹。本综述旨在综合最近的心血管衰老相关研究，以突出不同女性和男性人群的临床相关研究，这些研究可以为改善老年人群中CVD风险的诊断，管理和预后提供信息。
It is well known that cardiovascular disease (CVD) manifests differently in women and men. The underlying causes of these differences over the aging lifespan is less well understood. Sex differences in cardiac and vascular phenotypes are seen in childhood and tend to track along distinct trajectories related to dimorphism in genetic factors as well as response to risk exposures and hormonal changes over the life course. These differences underlie sex- specific variation in cardiovascular events later in life, including myocardial infarction, heart failure, ischemic stroke, and peripheral vascular disease. With respect to cardiac phenotypes, females have intrinsically smaller body-size-adjusted cardiac volumes and then tend to experience greater age-related wall thickening and myocardial stiffening with aging. With respect to vascular phenotypes, sexual dimorphism in both physiology and pathophysiology are also seen, including overt differences in blood pressure trajectories. The majority of sex differences in myocardial and vascular alterations that manifest with aging appear to follow relatively consistent trajectories from the very early to the very later stages of life. This review aims to synthesize recent cardiovascular aging-related research to highlight clinically relevant studies in diverse female and male populations that can inform approaches to improving the diagnosis, management, and prognosis of CVD risks in the aging population at large.