Table 1.

Examples of sex and gender differences in CVD and risk factors.

Diseases or risk factors	Sex differences	References
Myocardial infarction	Women are 10 years older than males and have higher mortality in younger ages and have more atypical symptoms. Women have less anatomical obstructive CAD than men; it is estimated a 20% or greater excess of normal or nonobstructive arteries in women vs men	[40–42]
Heart failure	Lower incidence in women but the prevalence is similar in both sexes, with diastolic heart failure being more common in women. Lower mortality rate in women than in men	[40, 41]
Hypertension	Lower incidence in premenopausal women	[40]
Cardiac hypertrophy	Premenopausal women are better protected than men; men have more cardiac hypertrophy	[40, 43]
Ischemia-reperfusion injury	Studies evidenced that females have lower ischemia-reperfusion injury	[40]
Diabetes	Higher increased risk of CVD in women vs men	[40]
Endothelial dysfunction	More frequent in women vs men	[44, 45]
HDL	Higher levels in women vs men; the difference declines with age	[46]
TG	Higher increased risk of CVD in women vs men. In women, they increase after menopause	[47]
Chol	Levels rise in menopausal transition period	[47]
LDL	Levels rise in menopausal transition period	[46]
Lp (a)	Levels rise in menopausal transition period	[46]
Smoking	Less women smoke vs men, but smoking has more negative effects on women	[48]
Social economicus status	In women, it is inversely associated with increased risk of CAD, stroke, and CVD. In particular, for CHD, it is associated with lower education	[49]
Psychological factors	Women had higher contributions from psychosocial risk factors (45.2% vs 28.8% in men)	[50, 51]
Unique for women
Gestational diabetes, pre-eclampsia, syndrome of polycystic ovary	Higher increased risk of CVD in women	[48, 52]
Oral contraceptives	A large cohort study (1.6 million of women, 15 to 49 years old) shows that ethinylestradiol (20 μg or 30 to 40 μg) is associated with an increased risk of MI. The risk is not significantly varied by progestin	[53]
	OC should not be prescribed for women over the age of 35 years and smokers (American College of Obstetricians and Gynecologists) and should be prescribed with caution in case of CV risk factors such as hypertension, diabetes, and dyslipidemia	[54]
Hormone replacement therapy	A large cohort study shows that ethinylestradiol is associated with an increased risk of MI that is not significantly changed with progestins	[55]