Trivedi Bhavi, Desai Rohan, Mishra Kunal, Hechanova Lisa Aimee, Abolbashari Mehran
Department of Internal Medicine, Texas Tech University Health Sciences Center El Paso, 145 W Castellano Dr., Apt #2, El Paso, TX, 79912, USA.
Department of Cardiovascular Medicine, University of Virginia, Charlottesville, VA, USA.
Curr Cardiol Rep. 2022 Dec;24(12):1791-1798. doi: 10.1007/s11886-022-01800-7. Epub 2022 Oct 21.
Atherosclerosis is the largest cause of death in the western world with the role of sex yet to be determined. The purpose of this review is to investigate the role sex may play in the development of atherosclerosis.
Differences in plaque burden play a role in atherosclerotic outcome. Men have a higher prevalence of plaque burden, while women have less plaque rupture, necrotic core, and calcium. Differences in hormones, vascular anatomy, and overall lifestyle all play a role. Estrogen's cardioprotective effect is well known, but there is a lack of consensus on testosterone's role. There are varying rates of atherosclerosis between the sexes. Studies have also shown varying differences in the progression of plaque and the type of plaques between sexes. Further investigations need to be done to solidify the role sex may play as a variable in the development of atherosclerosis and how that may impact future treatment goals.
动脉粥样硬化是西方世界最大的死因，而性别在其中所起的作用尚待确定。本综述的目的是研究性别在动脉粥样硬化发展过程中可能发挥的作用。
斑块负荷的差异在动脉粥样硬化的转归中起作用。男性斑块负荷的患病率较高，而女性的斑块破裂、坏死核心和钙化较少。激素、血管解剖结构和整体生活方式的差异均发挥作用。雌激素的心脏保护作用众所周知，但对于睾酮的作用尚无共识。两性之间动脉粥样硬化的发生率各不相同。研究还表明，两性之间斑块进展和斑块类型存在不同差异。需要进一步开展研究，以明确性别作为一个变量在动脉粥样硬化发展中可能发挥的作用，以及这可能如何影响未来的治疗目标。
