Background: The autonomic nervous system (ANS) is a key regulator of the
cardiovascular system. The two arms of the ANS, sympathetic and parasympathetic (vagal)
have co-regulatory effects on cardiac homeostasis. ANS modulation and dysfunction are also
believed to affect various cardiac disease states. Over the past decade, there has been increasing
evidence suggesting gender differences in ANS activity. Methods: In multiple previous
studies, ANS activity was primarily assessed using heart rate variability, muscle sympathetic
nerve activity, coronary blood flow velocity, and plasma biomarkers. Heart rate variability is
a non-invasive measure, which can be analyzed in terms of low frequency and high frequency
oscillations, which indicate the sympathetic and parasympathetic tone, respectively.
These measures have been studied between women and men in states of rest and stress, and
in cardiac disease. Conclusion: Studies support the concept of a significant gender difference
in ANS activity. Further studies are indicated to elucidate specific differences and
mechanisms, which could guide targeted therapy of various cardiovascular disease states.