Sex-Specific Considerations in the Presentation, Diagnosis, and Management of Ischemic Heart Disease: JACC Focus Seminar 2/7

J Am Coll Cardiol. 2022 Apr 12;79(14):1398-1406. doi: 10.1016/j.jacc.2021.11.065.


There are sex-related differences in the epidemiology, presentation, diagnostic testing, and management of ischemic heart disease in women compared with men. The adjusted morbidity and mortality are persistently higher, particularly in younger women and Blacks. Women have more angina but less obstructive coronary artery disease, which affects delays in presentation and diagnosis and testing accuracy. The nonbiological factors play a significant role in access to care, ischemic heart disease management, and guideline adherence. Future research focus includes sex-specific outcomes, characterization of the biological differences, and implementation science around quality of clinical care.

Keywords: coronary artery disease; ischemic heart disease; sex differences; women.

Publication types

  • Review
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Coronary Artery Disease* / diagnosis
  • Coronary Artery Disease* / epidemiology
  • Coronary Artery Disease* / therapy
  • Female
  • Humans
  • Male
  • Myocardial Ischemia* / diagnosis
  • Myocardial Ischemia* / epidemiology
  • Myocardial Ischemia* / therapy
  • Risk Factors
  • Sex Characteristics
  • Sex Factors