Figure 1. Sex Differences in Responses to Vascular Stressors and Sequelae.

A conventional paradigm proposes that when the same arterial structural and functional substrate is exposed to stressors, sex differences in response to these stressors lead to variations in manifest peripheral vascular disease including the predominance of aortic aneurysm and dissection in men as well as the likely higher prevalence of classic atherosclerotic lower extremity disease in women that also tends to present more as multivessel disease in women compared to men. Emerging evidence suggests that intrinsic sex differences in the arterial substrate, arising from genetic or epigenetic factors, likely also contribute to sexual dimorphism in vascular disease phenotypes.