The sex-dependent response to psychosocial stress and ischaemic heart disease

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Tessa J. Helman¹  Nady Braidy¹  Nicolas J. C. Stapelberg²  John P. Headrick³ 

[1] Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, NSW, Sydney, Australia;Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia;School, of Pharmacy and Medical Sciences, Griffith University, Southport, QLD, Australia;

关键词: sympathetic nervous system;    takotsubo cardiomyopathy;    chronic stress;    sexual dimophism;    glucocortcoids;    coronary artery disease;   

DOI  :  10.3389/fcvm.2023.1072042

 received in 2022-10-17, accepted in 2023-04-03,  发布年份 2023

来源: Frontiers

【 摘 要 】

Stress is an important risk factor for modern chronic diseases, with distinct influences in males and females. The sex specificity of the mammalian stress response contributes to the sex-dependent development and impacts of coronary artery disease (CAD). Compared to men, women appear to have greater susceptibility to chronic forms of psychosocial stress, extending beyond an increased incidence of mood disorders to include a 2- to 4-fold higher risk of stress-dependent myocardial infarction in women, and up to 10-fold higher risk of Takotsubo syndrome—a stress-dependent coronary-myocardial disorder most prevalent in post-menopausal women. Sex differences arise at all levels of the stress response: from initial perception of stress to behavioural, cognitive, and affective responses and longer-term disease outcomes. These fundamental differences involve interactions between chromosomal and gonadal determinants, (mal)adaptive epigenetic modulation across the lifespan (particularly in early life), and the extrinsic influences of socio-cultural, economic, and environmental factors. Pre-clinical investigations of biological mechanisms support distinct early life programming and a heightened corticolimbic-noradrenaline-neuroinflammatory reactivity in females vs. males, among implicated determinants of the chronic stress response. Unravelling the intrinsic molecular, cellular and systems biological basis of these differences, and their interactions with external lifestyle/socio-cultural determinants, can guide preventative and therapeutic strategies to better target coronary heart disease in a tailored sex-specific manner.

【 授权许可】

Unknown   
© 2023 Helman, Headrick, Stapelberg and Braidy.