Sex Differences in Cardiovascular Disease and Cognitive Impairment: Another Health Disparity for Women?

• Type of Material: Article
• Authors: Annabelle Santos Volgman, Rush Medical College; C. Noel Bairey Merz, Cedars Sinai Medical Center; Neelum T. Aggarwal, Rush Medical College; Vera Bittner, University of Alabama Birmingham; T. Jared Bunch, Stanford University; Philip B. Gorelick, Michigan State University; Pauline Maki, University of Illinois; Hena N. Patel, Rush Medical College; Athena Poppas, Brown University; Jeremy Ruskin, Massachusetts General Hospital; Andrea M. Russo, Rowan University; Shari R. Waldstein, University of Maryland; Nanette K Wenger, Emory University; Kristine Yaffe, University of California San Francisco; Carl J. Pepine, University of Florida
• Language: English
• Date: 2019-10-01
• Publisher: Wiley Open Access: Creative Commons Attribution Non-Commercial
• Publication Version: Final Published Version
• Copyright Statement: © 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1161/JAHA.119.013154
• Title of Journal or Parent Work: Journal of the American Heart Association
• ISSN: 2047-9980
• Volume: 8
• Issue: 19
• Start Page: e013154
• End Page: e013154
• Keywords: NEUROCOGNITIVE FUNCTION; VASCULAR PATHOLOGY; Life Sciences & Biomedicine; RISK-FACTORS; Science & Technology; complication; DIAGNOSTIC GUIDELINES; cardiac procedures; Cardiac & Cardiovascular Systems; HEART-FAILURE; ischemic heart disease; Alzheimer disease; POSTMENOPAUSAL WOMEN; Cardiovascular System & Cardiology; ALZHEIMERS ASSOCIATION WORKGROUPS; ATRIAL-FIBRILLATION; NATIONAL INSTITUTE; AORTIC-VALVE-REPLACEMENT; dementia; strokes; APOE
• Research Categories: Biology, Biostatistics

Abstract

Although the number of Americans dying of cardiovascular disease (CVD) continues to increase since 2010 after decades of decrease, advances in the management of CVD have led to increased longevity among both women and men, with more people, mostly women, now surviving into their 80s and beyond.1 Paralleling this increased longevity, however, is an increasing prevalence of, and mortality from, neurodegenerative cognitive disorders.1 These cognitive disorders include dementia, a syndrome that has a multitude of causes and symptoms that ultimately have substantial impact on social and occupational activities and aspects of daily living.2 Typical symptoms of dementia include changes in memory, problem solving, language, and executive functioning.2 Although there are often distinct patterns, symptoms, and specific brain pathology associated with different dementias, multiple autopsy studies are now demonstrating that people with symptoms of a dementia will often have multiple brain pathologies noted at autopsy that were associated with the dementia.3, 4 Multiple reports document that approximately two thirds of those clinically diagnosed with Alzheimer dementia are women.5 Furthermore, it is estimated that by 2040 the number of Americans with some form of cognitive impairment (CI), including dementia, will be ≈8.3 million women and ≈3.3 million men.5 This sex‐related CI disparity is concerning and raises important questions about its possible relation to CVD and CVD‐related risk factor conditions.