Background: In the last decades aging of population is becoming even more prevalent, with consequent increasing requirement in health assistance and services. Physical and social environments can affect health directly, or through barriers or incentives conditioning opportunities, decisions and behavior. Moreover, the relationship with environment varies according to several personal characteristics including family background, sex and ethnicity. The impact of these factors is often skewed by these characteristics, leading to inequalities in health. In virtually all countries, the older population is predominantly female. The prevalence and incidence of Cardiovascular Diseases (CVD) are reported to be lower in women than in men, increasing with age in both genders, but at advanced ages women outnumber men. Gender-differences in the contribution of various pathophysiological processes, combined with suboptimal recognition of female specificities, may explain sex-differences in presentation and outcomes of CVD and also partially explain the differences in cardiovascular drug therapy related to gender, where other behavioral and cultural factors can be involved.Purpose: Starting by the conflicting data in literature, the aim of this article is to summarize the gender differences available on the use of the main cardiovascular drugs, and the possible explanation for these disparities. Conclusion: Up to date, data on gender differences in cardiovascular therapy are still controversial, and overall no established factors have been identified to discriminate the different approach in the choice of cardiovascular drugs by gender. Then further more structured and bigger trials should be performed to target these issues, and to better clarify the underlining involved mechanisms.