Abstract-The sexual dimorphism of cardiovascular traits, as well as susceptibility to a variety of related diseases, has long been recognized, yet their sex-specific genomic determinants are largely unknown. We systematically assessed the sex-specific heritability and linkage of 539 hemodynamic, metabolic, anthropometric, and humoral traits in 120 French-Canadian families from the Saguenay-Lac-St-Jean region of Quebec, Canada. We performed multipoint linkage analysis using microsatellite markers followed by peak-wide linkage scan based on Affymetrix Human Mapping 50K Array Xba240 single nucleotide polymorphism genotypes in 3 settings, including the entire sample and then separately in men and women. Nearly one half of the traits were age and sex independent, one quarter were both age and sex dependent, and one eighth were exclusively age or sex dependent. Sex-specific phenotypes are most frequent in heart rate and blood pressure categories, whereas sex-and age-independent determinants are predominant among humoral and biochemical parameters. Twenty sex-specific loci passing multiple testing criteria were corroborated by 2-point single nucleotide polymorphism linkage. Several resting systolic blood pressure measurements showed significant genotypeby-sex interaction, eg, male-specific locus at chromosome 12 (male-female logarithm of odds difference: 4.16; interaction Pϭ0.0002), which was undetectable in the entire population, even after adjustment for sex. Detailed interrogation of this locus revealed a 220-kb block overlapping parts of TAO-kinase 3 and SUDS3 genes. In summary, a large number of complex cardiovascular traits display significant sexual dimorphism, for which we have demonstrated genomic determinants at the haplotype level. Many of these would have been missed in a traditional, sex-adjusted setting. T he sexual dimorphism of many physiological traits, as well as susceptibility to a wide variety of diseases, including hypertension, has long been recognized. 1 Both social and environmental factors, as well as biological influences, contribute to this dimorphism, yet their relative relevance is not well appreciated. Contributing genetic factors have been documented in both human subjects 2-4 and animal models. [5][6][7][8][9] However, only recent investigations into the sexspecific genetic architecture of complex traits led to the hypothesis that even the determinants of common conditions like hypertension, such as humoral regulation of volume, 10 and reaction to outcome events, such as myocardial infarction, 11 may have both unisex and sex-specific genetic determinants. 4 If that is the case, adjustment for sex during the analysis and interpretation of data may actually hide a significant portion of genome-driven physiology unique for men or women. Recent investigation found that less than one quarter of 628 recently published clinical cardiovascular studies reported sex-specific results. 12 There is a potentially sizeable impact of the genetically driven, sex-specific pathophysiology on clinical manag...