Sex and Gender and Allostatic Mechanisms of Cardiovascular Risk and Disease
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Sex and Gender and Allostatic Mechanisms of Cardiovascular Risk and Disease. / Longpré-Poirier, Christophe; Dougoud, Jade; Jacmin-Park, Silke; Moussaoui, Fadila; Vilme, Joanna; Desjardins, Gabriel; Cartier, Louis; Cipriani, Enzo; Kerr, Philippe; Le Page, Cécile; Juster, Robert Paul.
In: Canadian Journal of Cardiology, Vol. 38, No. 12, 12.2022, p. 1812-1827.Research output: Contribution to journal › Review › Research › peer-review
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TY - JOUR
T1 - Sex and Gender and Allostatic Mechanisms of Cardiovascular Risk and Disease
AU - Longpré-Poirier, Christophe
AU - Dougoud, Jade
AU - Jacmin-Park, Silke
AU - Moussaoui, Fadila
AU - Vilme, Joanna
AU - Desjardins, Gabriel
AU - Cartier, Louis
AU - Cipriani, Enzo
AU - Kerr, Philippe
AU - Le Page, Cécile
AU - Juster, Robert Paul
N1 - Publisher Copyright: © 2022 Canadian Cardiovascular Society
PY - 2022/12
Y1 - 2022/12
N2 - Cardiovascular diseases are leading causes of mortality and morbidity in adults worldwide. Multiple studies suggest that there are clinically relevant sex differences in cardiovascular disease. Women and men differ substantially in terms of prevalence, presentation, management, and outcomes of cardiovascular disease. To date, however, little is known about why cardiovascular disease affects women and men differently. Because many studies do not differentiate the concept of sex and gender, it is sometimes difficult to discriminate sociocultural vs biological contributors that drive observed clinical differences. Female sex has some biological advantages in relation to cardiovascular disease, but many of these advantages seem to disappear as soon as women develop cardiovascular risk factors (eg, type 2 diabetes, hypertension, dyslipidemia). Furthermore, stress and allostatic load could play an important role in the relationship between sex/gender and cardiovascular diseases. In this narrative review, we argue that chronic stress and psychosocial factors might better encompass the patterns of allostatic load increases seen in women, while biological risk factors and unhealthy behaviours might be more important mechanisms that drive increased allostatic load in men. Indeed, men show allostatic load patterns that are more associated with impaired anthropometric, metabolic, and cardiovascular functioning and women have greater dysregulation in neuroendocrine and immune functioning. Thus gender-related factors might contribute to the pathogenesis of cardiovascular disease especially through stress mechanisms. It is important to continue to study the mechanisms by which gender influences chronic stress, because chronic stress could influence modifiable gendered factors to promote cardiovascular disease prevention.
AB - Cardiovascular diseases are leading causes of mortality and morbidity in adults worldwide. Multiple studies suggest that there are clinically relevant sex differences in cardiovascular disease. Women and men differ substantially in terms of prevalence, presentation, management, and outcomes of cardiovascular disease. To date, however, little is known about why cardiovascular disease affects women and men differently. Because many studies do not differentiate the concept of sex and gender, it is sometimes difficult to discriminate sociocultural vs biological contributors that drive observed clinical differences. Female sex has some biological advantages in relation to cardiovascular disease, but many of these advantages seem to disappear as soon as women develop cardiovascular risk factors (eg, type 2 diabetes, hypertension, dyslipidemia). Furthermore, stress and allostatic load could play an important role in the relationship between sex/gender and cardiovascular diseases. In this narrative review, we argue that chronic stress and psychosocial factors might better encompass the patterns of allostatic load increases seen in women, while biological risk factors and unhealthy behaviours might be more important mechanisms that drive increased allostatic load in men. Indeed, men show allostatic load patterns that are more associated with impaired anthropometric, metabolic, and cardiovascular functioning and women have greater dysregulation in neuroendocrine and immune functioning. Thus gender-related factors might contribute to the pathogenesis of cardiovascular disease especially through stress mechanisms. It is important to continue to study the mechanisms by which gender influences chronic stress, because chronic stress could influence modifiable gendered factors to promote cardiovascular disease prevention.
UR - http://www.scopus.com/inward/record.url?scp=85140967867&partnerID=8YFLogxK
U2 - 10.1016/j.cjca.2022.09.011
DO - 10.1016/j.cjca.2022.09.011
M3 - Review
C2 - 36150584
AN - SCOPUS:85140967867
VL - 38
SP - 1812
EP - 1827
JO - Canadian Journal of Cardiology
JF - Canadian Journal of Cardiology
SN - 0828-282X
IS - 12
ER -
ID: 393779940