Gender Differences in Acute Aortic Dissection

Abstract

Cardiovascular disease (CVD) represents the most important cause of mortality and morbidity worldwide. There is heterogeneity in the epidemiology and management of CVD between male and female patients. In the specific case of acute aortic dissection (AAD), women, at the time of diagnosis, are older than men and complain less frequently of an abrupt onset of pain with delayed presentation to the emergency department. Furthermore, a history of hypertension and chronic obstructive pulmonary disease is more common among women. In type A AAD, women more often experience pleural effusion and coronary artery compromise, but experience less neurological and malperfusion symptoms. They undergo less frequent surgical treatment and have higher overall in-hospital mortality. Conversely, in type B AAD no significant differences were shown for in-hospital mortality between the two genders. However, it should be highlighted that further studies are needed in order to develop AAD gender specific preventive, diagnostic and therapeutic strategies.

Factors Related to Hospitalisation-Associated Disability in Patients after Surgery for Acute Type A Aortic Dissection: A Retrospective Study

“…Women were less frequently affected by type ATAAD than men. On the other hand, women tend to be older than men at the time of diagnosis [26]. This is similar to the characteristics of HAD, and further research focusing on gender differences is needed.…”

Prospective Evaluation of the Weekend Effect on Mortality Outcomes in Aortic Dissection

“…The results indicated that the studied population's average age was high and that there was a significant level of individual age variability. Multiple factors, including genetics, lifestyle, and overall health, could be responsible for the age range level [30].…”

Epidemiology of Acute Aortic Dissection in a General Population of 1.4 Million People in Japan ― Shiga Stroke and Heart Attack Registry ―

“…18 Recent population-based registries also reported a male predominance in both subtypes. 19 However, 2 previous reports from Japan indicated that the proportion of women was higher among patients with type A-AAD compared with those with type B-AAD. 17, 20 Goda et al surveyed the differences in the characteristics of patients with type A-AAD between Belgian and Japanese centers, and reported that Japanese women were more likely to develop type A-AAD than Belgian women.…”