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Betai D, Ahmed AS, Saxena P, Rashid H, Patel H, Shahzadi A, Mowo-Wale AG, Nazir Z. Gender Disparities in Cardiovascular Disease and Their Management: A Review. Cureus 2024; 16:e59663. [PMID: 38836150 PMCID: PMC11148660 DOI: 10.7759/cureus.59663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2024] [Indexed: 06/06/2024] Open
Abstract
Worldwide, cardiovascular diseases (CVDs) are still the primary cause of death, and there are notable differences between sexes when it comes to symptoms/course and treatment. Due to evolving healthcare technologies, significant progress has been made in understanding CVDs. Hence, it is evident that gender disparities exist in the clinical presentation, prevalence, management, outcomes, and risk factors, including biological, behavioral, and sociocultural factors. This narrative review is designed to provide a generalized idea of gender disparities in CVDs. It aims to provide insights to prove the role of hormonal influences, genetic predispositions, and the difference in physiological outcomes owing to different genders. This review explores subtle distinctions in CVD across genders, including changes in structure, biology, and hormones that affect how illness presents and progresses. Lifestyle variables also influence sociocultural factors and gender disparities in risk profiles. Traditional risk factors, diabetes mellitus (DM), cholesterol levels, and smoking may have different weights and relevance in men and women. Moreover, age and other conventional risk variables have distinct effects on gender. Treatment efficacy may be impacted by the expression of gender-specific factors, emphasizing the necessity for customized strategies. Development of CVDs can be delayed or prevented, and its consequences can be lessened with the early identification and effective management of gender-specific factors. More investigation is necessary to clarify complex interactions between structural, biochemical, and hormonal aspects across genders in order to maximize treatment results and reduce the burden of CVDs.
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Affiliation(s)
- Dhruva Betai
- General Practice, Pandit Deendayal Upadhyay Medical College, Rajkot, IND
| | - Aamina S Ahmed
- Internal Medicine, St. George's University School of Medicine, New York, USA
| | - Prerna Saxena
- Medicine and Surgery, K. S. Hegde Medical Academy, Mangalore, IND
| | - Hurria Rashid
- Basic Sciences, Fatima Jinnah Medical University, Lahore, PAK
| | - Happy Patel
- Internal Medicine, Angeles University Foundation, Angeles City, PHL
| | - Atika Shahzadi
- Medicine, Aziz Bhatti Shaheed Teaching Hospital, Gujrat, PAK
| | | | - Zahra Nazir
- Internal Medicine, Combined Military Hospital Quetta, Quetta, PAK
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De Rosa S, Brida M, Grapsa J, Dos Subira L, Bäck M, Chieffo A. Women in Cardiology. EUROPEAN HEART JOURNAL OPEN 2023; 3:oead122. [PMID: 38105919 PMCID: PMC10724110 DOI: 10.1093/ehjopen/oead122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/15/2023] [Accepted: 11/19/2023] [Indexed: 12/19/2023]
Affiliation(s)
- Salvatore De Rosa
- Department of Medical and Surgical Sciences, Magna Graecia University, Viale Europa, 88100 - Catanzaro, Italy
| | - Margarita Brida
- Department of Medical Rehabilitation, Medical Faculty University of Rijeka, Rijeka, Croatia
- Royal Brompton & Harefield Hospitals, Guys & St Thomas’s NHS Trust and Imperial College, London, UK
| | - Julia Grapsa
- Department of Cardiology, Guys and St Thomas NHS Trust, London, UK
| | - Laura Dos Subira
- Integrated Adult Congenital Heart Disease Unit, Vall d'Hebron University Hospital-Santa Creu i Sant Pau University Hospital, Barcelona, Spain
| | - Magnus Bäck
- Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
| | - Alaide Chieffo
- Department of Medicine, Vita Salute San Raffaele University,Milan, Italy
- Interventional Cardiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Vilela EM, Oliveira C, Oliveira C, Torres S, Sampaio F, Primo J, Ribeiro J, Teixeira M, Oliveira M, Bettencourt N, Viamonte S, Fontes-Carvalho R. Sixty years of the Bruce protocol: reappraising the contemporary role of exercise stress testing with electrocardiographic monitoring. Porto Biomed J 2023; 8:e235. [PMID: 37846299 PMCID: PMC10575366 DOI: 10.1097/j.pbj.0000000000000235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 09/18/2023] [Indexed: 10/18/2023] Open
Abstract
The cardiovascular response to exercise has long been a focus of interest. Over a century ago, the first descriptions of electrocardiographic changes occurring during exercise highlighted the possible relevance of this dynamic assessment. In this background, the inception of the Bruce protocol circa 60 years ago allowed for a major leap in this field by providing a standardized framework with which to address this issue, by means of an integrated and structured methodology. Since then, exercise stress testing with electrocardiographic monitoring (ExECG) has become one of the most widely appraised tests in cardiovascular medicine. Notably, past few decades have been profoundly marked by substantial advances in the approach to cardiovascular disease, challenging prior notions concerning both its physiopathology and overall management. Among these, the ever-evolving presentations of cardiovascular disease coupled with the development and implementation of several novel diagnostic modalities (both invasive and noninvasive) has led to a shifting paradigm in the application of ExECG. This technique, however, has continuously shown to be of added value across various momentums of the cardiovascular continuum, as depicted in several contemporary guidelines. This review provides a pragmatical reflexion on the development of ExECG, presenting a comprehensive overview concerning the current role of this modality, its challenges, and its future perspectives.
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Affiliation(s)
- Eduardo M. Vilela
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Cátia Oliveira
- Cardiology Department, Hospital de Braga, Braga, Portugal
- Faculty of Medicine, Minho University, Braga, Portugal
| | - Cláudia Oliveira
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Susana Torres
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Francisco Sampaio
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
- Cardiovascular Research Center (UniC@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - João Primo
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - José Ribeiro
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Madalena Teixeira
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Marco Oliveira
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Nuno Bettencourt
- Cardiovascular Research Center (UniC@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Sofia Viamonte
- North Rehabilitation Centre, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Ricardo Fontes-Carvalho
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
- Cardiovascular Research Center (UniC@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
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