Background: Cardiovascular disease has been the leading cause of death in both
sexes in developed countries for decades. In general, men and women share the same cardiovascular
risk factors. However, in recent trials including both men and women sexspecific
analyses have raised awareness of sex differences in cardiovascular risk factors due
to both biological and cultural differences.
Results: Women experience their first myocardial infarction (MI) 6-10 years later than men
and a protective effect of their natural estrogen status prior to menopause has been suggested.
Female sex hormones have been associated with a less atherogenic lipid profile and a
more healthy fat distribution. These differences are attenuated following menopause. Regarding
life style the prevalence of smoking is highest in men but female smokers have a
relatively higher cardiovascular risk than male smokers. Men are more physically active than
women while women have healthier dietary habits. Genetic factors also affect cardiovascular
risk but no sex differences have been seen. Increased cardiovascular risk attributed to psychosocial distress is
similar in men and women, but since women are more prone to psychosocial distress their burden of disease is
greater. Compared with a healthy population the relative risk of MI in a diabetic population is higher in women
than in men. No sex difference exists in the prevalence of hypertension but it has an earlier onset in men.
Conclusion: Sex differences in cardiovascular risk are becoming more apparent and paying attention to this is
pivotal when addressing risk factors in preventive efforts.