Gender Disparities in Cardiovascular Health: A Review of Risk Factors, Clinical Presentation, and Associated Outcomes

Cardiovascular disease (CVD) remains the leading cause of death globally and accounts for approximately one-third of all global deaths. Coronary artery disease is the most common type of CVD; 1 in 20 adults ages 20 and older has coronary artery disease. This literature review will examine the sex and gender disparities that exist regarding risk factors, clinical presentation, and clinical outcomes of CVD. Traditional and nontraditional risk factors of CVD that are highlighted include smoking, diabetes, high blood pressure, dyslipidemia, obesity, depression, psychosocial factors, autoimmune disease, and physical inactivity. These risk factors affect both sexes but lead to a disproportionately higher risk of CVD in women. Female-specific risk factors, such as hypertensive disorders of pregnancy, and male-specific risk factors, such as testosterone deficiency, also demonstrate associations with CVD risk. Biological, structural, and hormonal differences between men and women are also prominent and significantly affect the progression of cardiovascular health. Improved recognition of sex-based differences in risk and presentation is essential for reducing morbidity and mortality as it relates to cardiovascular health.