Hemodynamic Stress as a Cause of the High Prevalence of Arterial Disease in Women.

Abstract

Background: Intracranial aneurysms, spontaneous coronary artery dissection, and fibromuscular dysplasia are significantly more common in women than in men, but the cause of these diseases and the cause of the predominance in women are unknown. It is also unclear whether and how genetic factors (genetic disposition or genetic pleiotropy) can influence the development of these diseases. A literature search in PubMed was conducted to identify the causes of the three arterial diseases. Particular attention was paid to the hemodynamic load on the arteries.

Summary: The imbalance of body fluids in pregnancy, menstruation, and premenstrual syndrome contributes to structural changes in the arterial wall and can promote arterial diseases.

Key messages: Increase in blood volume, high blood flow velocity, and edema of the vessel wall are factors that contribute to arterial diseases and can explain the predominance of some arterial diseases in women. These hemodynamic factors are to be distinguished from genetic causes, arteriosclerosis, or inflammatory diseases.