Sex-Specific Physiology and Cardiovascular Disease

  • Chrisandra L. ShufeltEmail author
  • Christine Pacheco
  • Marysia S. Tweet
  • Virginia M. Miller
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1065)


Sex differences in cardiovascular diseases can be classified as those which are specific to one sex and those that differ in incidence, prevalence, etiology, symptomatology, response to treatment, morbidity, and mortality in one sex compared to the other. All sex differences in cardiovascular conditions have their basis in the combined expression of genetic and hormonal differences between women and men. This chapter addresses how understanding basic mechanisms of hormone responses, imaging diagnostics, and integration of genomics and proteomics has advanced diagnosis and improved outcomes for cardiovascular conditions, apart from those related to pregnancy that are more prevalent in women. These conditions include obstructive coronary artery disease, coronary microvascular dysfunction, spontaneous coronary artery dissection, diseases of the cardiac muscle including heart failure and takotsubo cardiomyopathy, and conditions related to neurovascular dysregulation including hot flashes and night sweats associated with menopause and effects of exogenous hormones on vascular function. Improvement in technologies allowing for noninvasive assessment of neuronally mediated vascular reactivity will further improve our understanding of the basic etiology of the neurovascular disorders. Consideration of sex, hormonal status, and pregnancy history in diagnosis and treatment protocols will improve prevention and outcomes of cardiovascular disease in women as they age.


Atrial fibrillation Cardiomyopathy Endothelial dysfunction Coronary microvascular dysfunction 17β-Estradiol Heart failure Hot flashes Ischemic nonobstructive coronary artery disease INOCA Menopause Migraine SCAD Spontaneous coronary artery dissection Takotsubo Vasomotor symptoms 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Chrisandra L. Shufelt
    • 1
    Email author
  • Christine Pacheco
    • 1
  • Marysia S. Tweet
    • 2
  • Virginia M. Miller
    • 3
  1. 1.Barbra Streisand Women’s Heart CenterCedars-Sinai Medical Center, Smidt Heart InsitituteLos AngelesUSA
  2. 2.Department of Cardiovascular MedicineCollege of Medicine, Mayo ClinicRochesterUSA
  3. 3.Surgery and PhysiologyWomen’s Health Research Center, College of Medicine, Mayo ClinicRochesterUSA

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