A recent article assessing that women have significantly different biomarkers associated with cardiovascular disease (CVD) is prompting the clinical community to reevaluate what criteria should be used to diagnose, prevent, and manage CVD in women.
Key Points: Not only are biomarkers dissimilar in women vs men, but the development of CVD is also quite different. Recent work by Dr. James de Lemos has shown that not only hormonal differences in CVD exist for men and women, but it has been assessed that biochemical pathways towards CVD development are gender specific as well– which was not previously understood. Dr. Lemos and his team at UT Austin evaluated over 3000 participants from the Dallas Heart Study (DHS), a cohort based population study of multiethnic Dallas County adults. Results showed sex-based differences in various measurements including lipids, adipokine levels and biomarkers for inflammation, endothelial dysfunction, myocyte injury due to stress, and kidney function.
These distinctions are likely intrinsic differences between genders, but further investigation is needed to explain the physiological differences found in these results. The data discovered should be utilized by the clinical community when evaluating CVD risk to ultimately understand the ‘why.’ Current research shows the need for more personalized, gender specific management for CVD prevention. Past studies have evaluated the need for patient management plans based on age and race and these data underscore the need to consider gender as well. In addition, weight has been shown to play a large role in CVD development. Dr. Lemos and other recent clinical trials have found that waist circumference, more than BMI, is an important indicator of CVD and should be discussed with patients early to hinder the development of CVD and its progression.
While further research is needed, recent data points to the fact that ‘one size does not fit all’ when it comes to CVD management and that gender, race, age, and waist circumference are playing major roles in disease development and should be evaluated when developing individualized patient plans for the management of CVD.
Why is this clinically relevant?
- Criteria for assessment of CVD and risk needs to be reevaluated based on current research publication
- Race, gender, and waist circumference need to be considered to prevent or treat CVD
- Not just hormonal differences, but biological differences, exist for CVD between men and women
Ethnic Differences in BMI and Disease Risk. Obesity Prevention Source. 2017. Available at: https://www.hsph.harvard.edu/obesity-prevention-source/ethnic-differences-in-bmi-and-disease-risk/. Accessed March 13, 2017.
Chen Z, Klimentidis Y, Bea J et al. Body Mass Index, Waist Circumference, and Mortality in a Large Multiethnic Postmenopausal Cohort-Results from the Women’s Health Initiative. Journal of the American Geriatrics Society. 2017. doi:10.1111/jgs.14790.