2018
DOI: 10.1152/ajpheart.00132.2018
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New insights into arterial stiffening: does sex matter?

Abstract: This review discusses sexual dimorphism in arterial stiffening, disease pathology interactions, and the influence of sex on mechanisms and pathways. Arterial stiffness predicts cardiovascular mortality independent of blood pressure. Patients with increased arterial stiffness have a 48% higher risk for developing cardiovascular disease. Like other cardiovascular pathologies, arterial stiffness is sexually dimorphic. Young women have lower stiffness than aged-matched men, but this sex difference reverses during … Show more

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Cited by 90 publications
(72 citation statements)
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References 231 publications
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“…Remodeling and stiffening result from interacting mechanical, humoral and cellular factors including hemodynamic stress, endothelial dysfunction, vascular inflammation, immune cell infiltration, and calcium deposition 69,70 . Both processes are driven by overlapping mediators including inflammatory cytokines, sex hormones, angiotensin-II (AngII), endothelin, aldosterone, and oxidative stress 71 . In addition, modifications of the extracellular matrix plays an essential role in stiffening.…”
Section: What Causes Remodeling and Stiffening?mentioning
confidence: 99%
See 1 more Smart Citation
“…Remodeling and stiffening result from interacting mechanical, humoral and cellular factors including hemodynamic stress, endothelial dysfunction, vascular inflammation, immune cell infiltration, and calcium deposition 69,70 . Both processes are driven by overlapping mediators including inflammatory cytokines, sex hormones, angiotensin-II (AngII), endothelin, aldosterone, and oxidative stress 71 . In addition, modifications of the extracellular matrix plays an essential role in stiffening.…”
Section: What Causes Remodeling and Stiffening?mentioning
confidence: 99%
“…A deficit in endothelial nitric oxide (NO) and free radicals may play an important role in remodeling. 56,71 In the aorta perivascular macrophages (PVM) expressing the lymphatic hyaluronan receptor LYVE1 safeguard the elasticity of the vascular wall by governing collagen content in smooth muscle cells through hyaluronan and pericellular matrix metalloprotease-9. 72 Although LYVE1+ PVM are present also in cerebral arteries, 72,73 it remains unclear if they serve a similar role in the homeostasis of the cerebrovascular wall.…”
Section: What Causes Remodeling and Stiffening?mentioning
confidence: 99%
“…Studies directly linking the impact of the gut microbiome on sex differences in BP and hypertension are scarce. Arterial stiffness is closely related to hypertension; it is an independent predictor of cardiovascular risk and is particularly relevant to women, who see a marked rise in vascular stiffness after menopause, mirroring the rise in hypertension after menopause [66]. The decline in oestrogen clearly plays a central role in this relationship, but factors such as inflammation also contribute [67].…”
Section: Introductionmentioning
confidence: 99%
“…Overall, there is substantial evidence supporting an effect of sex hormone on vascular stiffness (Ogola et al 2018;DuPont et al 2019) . Over the lifespan, arterial stiffness increases linearly in both males and females however there is a more rapid increase in stiffness in females due to depletions in estrogen levels post menopause (Mitchell 2014;DuPont et al 2019) .…”
Section: Arterial Stiffness and Cerebrovascular Reactivitymentioning
confidence: 99%