Sex hormones and sex chromosomes cause sex differences in the development of cardiovascular diseases

Arthur P. Arnold, Lisa A. Cassis, Mansoureh Eghbali, Karen Reue, Kathryn Sandberg

Research output: Contribution to journalReview articlepeer-review

204 Scopus citations


This review summarizes recent evidence concerning hormonal and sex chromosome effects in obesity, atherosclerosis, aneurysms, ischemia/reperfusion injury, and hypertension. Cardiovascular diseases occur and progress differently in the 2 sexes, because biological factors differing between the sexes have sex-specific protective and harmful effects. By comparing the 2 sexes directly, and breaking down sex into its component parts, one can discover sex-biasing protective mechanisms that might be targeted in the clinic. Gonadal hormones, especially estrogens and androgens, have long been found to account for some sex differences in cardiovascular diseases, and molecular mechanisms mediating these effects have recently been elucidated. More recently, the inherent sexual inequalities in effects of sex chromosome genes have also been implicated as contributors in animal models of cardiovascular diseases, especially a deleterious effect of the second X chromosome found in females but not in males. Hormonal and sex chromosome mechanisms interact in the sex-specific control of certain diseases, sometimes by opposing the action of the other.

Original languageEnglish
Pages (from-to)746-756
Number of pages11
JournalArteriosclerosis, Thrombosis, and Vascular Biology
Issue number5
StatePublished - May 1 2017

Bibliographical note

Publisher Copyright:
© 2017 American Heart Association, Inc.


  • androgen effects
  • atherosclerosis
  • coronary artery disease
  • estrogen effects
  • gonosomes
  • heart failure
  • obesity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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