The role of sex in cardiac function and disease

Can J Physiol Pharmacol. 2006 Jan;84(1):93-109. doi: 10.1139/y05-151.


In the past decade, increasing attention has been paid to the importance of sex in the etiology of cardiac dysfunction. While focus has been primarily on how sex modulates atherogenesis, it is becoming clear that sex is both a predictor of outcome and an independent risk factor for a number of other cardiac diseases. Animal models and human studies have begun to shed light on the mechanisms by which sex influences the function of cardiomyocytes in health and disease. This review will survey the current literature on cardiac diseases that are influenced by sex and discuss the intracellular mechanisms by which steroid sex hormones affect heart function. A theory on how sex may regulate myocardial energy metabolism to affect disease susceptibility and progression will be presented, as well as a discussion of how sex may influence outcomes of experiments on isolated cardiomyocytes by epigenetic marking.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Androgens / metabolism
  • Animals
  • Aromatase / metabolism
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / metabolism
  • Disease Susceptibility
  • Estrogens / metabolism
  • Female
  • Gonadal Steroid Hormones / metabolism*
  • Heart / physiology
  • Humans
  • Male
  • Progestins / metabolism
  • Sex Factors


  • Androgens
  • Estrogens
  • Gonadal Steroid Hormones
  • Progestins
  • Aromatase