Eicosanoid Expression of Vascular Sexual Dimorphism

Abstract

Sexual dimorphism is prominent in cardiovascular disease. Morbidity is generally greater in women but mortality is higher in men. Thus, death rates from coronary atherosclerotic disease are two- to fivefold higher in men than in women particularly in the premenopausal age groups [10]. Genetic, environmental, and social factors may all contribute to gender differences in mortality [22,16]. Puberty and the secretion of gonadal hormones are thought to be important but still unresolved factors. Androgen secretion, for example, as distinct from genetic maleness, was suggested as a risk factor 30 years ago [13] and there is more recent clinical support for this concept [15]. Lately estrogen has been implicated as a male risk factor in myocardial infarction but it is now difficult to continue to sustain this proposition [12]. A stronger hypothesis is that estrogen is a protective factor in women with respect to atherosclerosis [17].