Sex Differences and Similarities in Valvular Heart Disease

As populations age worldwide, the burden of valvular heart disease has grown exponentially, and so has the proportion of affected women. Although rheumatic valve disease is declining in high-income countries, degenerative age-related causes are rising. Calcific aortic stenosis and degenerative mitral regurgitation affect a significant proportion of elderly women, particularly those with comorbidities. Women with valvular heart disease have been underrepresented in many of the landmark studies which form the basis for guideline recommendations. As a consequence, surgical referrals in women have often been delayed, with worse postoperative outcomes compared with men. As described in this review, a more recent effort to include women in research studies and clinical trials has increased our knowledge about sex-based differences in epidemiology, pathophysiology, diagnostic criteria, treatment options, outcomes, and prognosis.

Automated summary

As the global population ages, the burden of valvular heart disease has increased substantially, affecting a larger proportion of women. While rheumatic valve disease is declining in high-income countries, age-related degenerative causes are on the rise. Calcific aortic stenosis and degenerative mitral regurgitation significantly affect elderly women, especially those with comorbidities. Women with valvular heart disease have been underrepresented in important research studies, leading to delayed surgical referrals and poorer postoperative outcomes compared to men. Recent efforts to include women in research and clinical trials have provided valuable insights into sex-based differences in epidemiology, pathophysiology, diagnosis, treatment options, outcomes, and prognosis.