Institute of Physiology and Science-IT, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Semmelweis University, Department of Family Medicine and Health Service of Zuglo (ZESZ), Budapest, Hungary.
Heart Lung Circ. 2021 Nov;30(11):1637-1646. doi: 10.1016/j.hlc.2021.07.006. Epub 2021 Aug 25.
Sex and gender are important modifiers of cardiovascular system physiology, pathophysiology, and disease development. The atherosclerosis process, together with the progressive loss of arterial elasticity with age, is a major factor influencing the development of overt cardiovascular, renal, and cerebrovascular disease. While differences between women and men in epidemiology and pathophysiology of vascular ageing are increasingly reported, sex-disaggregated data are still scarcely available for prospective studies. A better knowledge of sex differences in physiological ageing as well as in disease-related changes in vascular ageing trajectories is crucial to avoid misdiagnosis and mistreatment. This review presents key concepts and knowledge gaps identified in vascular ageing due to gonadal function, vascular physiology, pathophysiology, psychosocial factors, pregnancy, and prognostic relevance. Gender roles determine the effectiveness of any cardiovascular preventive strategy and acceptance for non-invasive or invasive diagnostics and therapeutics. Gender differences in health behaviour, also due to sociocultural norms conditioned by society, contribute to behaviours that may lead to premature arterial vascular ageing. These include differences in risk behaviours like smoking, diet, exercise, and in stress, but also conditions such as housing, noise pollution, poverty, disability, and any kind of stigmatisation. The VascAgeNet Gender Expert Group aims to advance the use of non-invasive vascular ageing measures in routine clinical settings by providing facts to fill in the gaps concerning sex and gender differences at each step of this process, and to search for solutions.
性别是心血管系统生理学、病理生理学和疾病发展的重要调节剂。动脉粥样硬化过程以及随年龄增长动脉弹性的逐渐丧失，是影响明显心血管、肾脏和脑血管疾病发展的主要因素。尽管越来越多的研究报告了血管老化的流行病学和病理生理学方面的男女差异，但在前瞻性研究中，仍然缺乏性别分类数据。更好地了解生理衰老和与疾病相关的血管老化轨迹变化中的性别差异，对于避免误诊和误治至关重要。这篇综述介绍了由于性腺功能、血管生理学、病理生理学、心理社会因素、妊娠以及预后相关性而导致的血管老化方面的关键概念和知识空白。性别角色决定了任何心血管预防策略的有效性以及对非侵入性或侵入性诊断和治疗的接受程度。健康行为方面的性别差异，也归因于社会条件下的社会文化规范，导致可能导致动脉血管过早老化的行为。这些行为包括不同的风险行为，如吸烟、饮食、运动和压力，还包括住房、噪声污染、贫困、残疾和任何形式的污名化等情况。VascAgeNet 性别专家组旨在通过提供事实来填补这一过程中每个步骤的性别差异的空白，推进常规临床环境中使用非侵入性血管老化测量，寻找解决方案。
