Gender Differences in Cardiac Hypertrophy

The 2020 review article examined gender differences in cardiac hypertrophy, an enlargement of the heart due to stress or disease. It found that females generally have a more favorable hypertrophic response than males, but the condition is a stronger risk factor for heart failure in females once established. Pre-menopausal women are better protected against cardiac hypertrophy than men, with this protection waning after menopause but partially recoverable with estrogen replacement therapy. Estrogen was shown to inhibit pro-hypertrophy pathways, while androgen promoted them. The review also noted that post-puberty, physiological cardiac hypertrophy is more pronounced in men, but women maintain better myocardial and systolic function as they age. Human and animal studies indicated that female athletes have a significant hypertrophic response to exercise, with differences in cardiac function and metabolism compared to males. The role of sex hormones, particularly estrogen and androgen, was emphasized in influencing these gender differences, with estrogen receptors, especially ERβ, implicated in physiological hypertrophy in females. The document suggests that a deeper understanding of these mechanisms could lead to gender-specific treatments for heart failure.