简介：Coronaryarterydisease(CAD)istheleadingcauseofdeathworldwide,butbecauseofseveralfactors,oneofwhichisantiplatelettherapy,themortalityrateshavesteadilydeclined.However,womencontinuetoexperiencehigherCADmortalityratesthanmen.Thismaybeexplainedbydifferencesincomorbidities,increasedtimetopresentation,higherbleedingrates,anddifferencesinmanagement.Therearenumerouslandmarktrialsinthefieldofantiplatelettherapy;however,womenareconsistentlyunderrepresentedinthesetrials.Theresultsofthesetrialsrevealthatwomenexperiencethesamebenefitasmenfromantiplatelettherapybutexperiencehigherbleedingrates;thereforebleeding-reductionstrategiesareimperativeinthispatientpopulation.ThisreviewprovidesanoverviewoftheavailableevidenceonCADinwomenanditsimplicationsforantiplateletmedications.

简介：APeruviannative,Dr.VelardeearnedhermedicaldegreefromtheNewYorkUniversitySchoolofMedicineinNewYorkandwentontocompleteherresidencytraininginInternalMedicineatColumbiaPresbyterianMedicalCenterandCardiovascularDiseasefellowshiptrainingatMountSinaiHospitalinNewYorkandBostonUniversity.Dr.GladysP.VelardeisAssociateProfessorofMedicine/CardiologyatTheUniversityofFlorida,JacksonvillewhereshedirectstheWomen’sCardiovascularHealthProgramandisDirectoroftheCardiovascularDiseaseFellowshiptrainingprogram.

简介：ObstructiveSleepApnea(OSA)isacommonchronicdisorderthataffects5–10%oftheUSpopulationwithahigherprevalenceinmencomparedtowomenby2:1inpopulationstudies.Bycontrast,inpatientswithcardiovasculardisease,itsprevalencecanexceed50%dependingonthespecificdisordersurveyed.Althoughsexdifferenceshavebeenwelldescribedforcardiovascularriskfactors;existingdataregardingtheimpactofsexontherelationshipbetweenOSAandcardiovascularoutcomesiscontroversial.Similarly,whilethereisstrongevidenceforincreasedprevalenceofcardiovascularconditions,suchassystemichypertension,atrialfibrillation,aswellasheartfailureamongstpatientssufferingfromOSA;conflictingevidenceexistsregardingtheincidenceandbidirectionalrelationshipbetweenthemaswellastheimpactoftreatmentofOSAoncardiovascularoutcomes.Inthispaper,wewillreviewtheassociationsbetweenOSAandcardiovasculardiseasesinwomen.Thedataonsexdifferencesislimited,duetoanumberofreasons,including,butnotlimitedtolatepresentationofOSAinwomen,difficultiesindiagnosingbothOSAandcardiovasculardiseasesinwomenandstillsuboptimalinclusionofadequatenumberofwomeninclinicaltrials.MorestudiesareneededtobetterdelineatesexdifferencesintheclinicalpresentationaswellasthepathophysiologyoftheassociationsbetweenOSAandcardiovasculardiseasessothatwecanprovidepatientswithmorepersonalizedcare.

简介：Depression/anxiety-relateddisordersandpsychosocialstresshavebeenimplicatedascardiovasculardisease(CVD)riskfactors.Womenareatconsiderableriskforaffectivedisordersandreportgreaterseverityfrompsychosocialstress,comparedtomen.Affectivedisordersandcardiovasculardiseaselikelyshareunderlyingpathophysiologicalmechanismsthatarepotentiatedamongwomen–especiallyyoungerwomen.Environmentalstressorsthatthreatenthesafety,security,andstatusofanindividualareappraisedbythebrain,producingacascadeofevokedphysiologicalandcognitiveresponses.Intheshortterm,theseprocessesovercomestressors,butcomewithlong-termhealthimplications.Chronicpsychosocialstressleadstoadysregulationofthestressresponsesystemsthatcanleadtoaheightenedstressappraisalschemacalledtheunpredictabilityschema,aconstructthatmightarguablyplacewomenatheightenedriskforCVD.

简介：Therehasbeenanappropriatefocus,sincetheturnofthe21stcentury,onsex-andgender-specificcardiovasculardisease(CVD)asincreasingevidencesuggeststhattherearesubstantialdifferencesintheriskfactorprofile,socialandenvironmentalfactors,clinicalpresentation,diagnosis,andtreatmentofischemicheartdiseaseinwomencomparedwithmen.Asaresultofincreasedawareness,detection,andtreatmentofischemicheartdiseaseinwomen,therehasbeensignificantreduction(greaterthan30%)incardiovascularmortality,andin2013,moreUSmenthanUSwomendiedofCVD.Nevertheless,continuedeffortsarerequiredasCVDremainstheleadingcauseofcardiovascularmorbidityanddeathofwomenintheWesternworld,andinwomenyoungerthan55yearstherehasbeenariseincardiovascularmortality.Inthisarticle,wereviewseveralofthecontributingfactorsthatcontinuetocausechallengesinaccurateriskpredictionandriskstratificationinwomen.

简介：Conventionalrecommendationsfordiagnostictestingfortheevaluationofstableischemicheartdiseaseinwomenhavelargelyparalleledthoseinmen.Althoughtheyaredesignedprimarilyfortheidentificationofobstructivecoronaryarterydisease(CAD),traditionalapproachescanleadtoovertestinginwomenwithoutdifferentiatingwhoistrulyatrisk.Severaluniquefactorsrelatedtothepresentation,diagnosis,andunderlyingpathophysiologyofstableischemicheartdiseaseinwomennecessitateamorespecificapproachtotheassessmentoftheirrisk,completewithseparateguidelineswhenappropriate.Thisoverviewhighlightshowadvancednoninvasiveimagingtools,includingcardiaccomputedtomographyangiography,positronemissiontomography,andcardiacmagneticresonanceimaging,areenablingverysensitiveassessmentsofanatomicatheroscleroticplaqueburden,macrovessel-andmicrovessel-relatedischemia,andmyocardialfibrosis,respectively.Movingforward,effectivediagnostictestingwillneedtoidentifywomenathighriskofadversecardiovascularevents(notanatomicallyobstructiveCADperse)withoutovertestingthoseatlowrisk.JudiciousapplicationofnovelimagingapproacheswillbecriticaltobroadeningthedefinitionsofCADandischemiatobetterreflectthewholespectrumofpathologicalphenotypesinwomen,includingnonobstructiveCADandcoronarymicrovasculardysfunction,andaidinthedevelopmentofneededevidence-basedstrategiesfortheirmanagement.

简介：Sex-specificdifferencesintheepidemiologyandpathophysiologyofcoronaryarterydiseaseandischemicheartdiseasearenowwellrecognized.Womenwithanginamoreoftenhavenonobstructivecoronaryarterydisease(NOCAD)comparedwithmen.Thispatientpopulationcarriesasignificantriskoffuturecardiovasculareventsthatisnotcommonlyappreciated,oftenleadingtodelayeddiagnosisandtreatment.WhilecoronarymicrovasculardysfunctionplaysacentralroleinthepathophysiologyofNOCADinwomen,othermechanismsofmyocardialischemiaarenowrecognized.RiskfactorssuchashypertensionandobesitydisparatelyaffectwomenandarelikelytoaccountforasignificantproportionofNOCADinthecomingyears.VascularinflammationisanimportantpathophysiologicpathwayinNOCADandisapotentialtherapeutictarget.CoronaryCTangiographyprovidesacomprehensiveassessmentofcoronaryanatomyandplaquemorphologyandisareasonablescreeningtestofchoiceforNOCAD.