This manual defines sex and gender differences in cardiovascular disease and how they have become an important topic within most subspecialities in the field of cardiology. It is now evident that sex differences in biology and lifestyle influence the pathophysiology of heart disease. Consequently risk factors for cardiac disease are modified by sex and gender, and women and men develop partly different variants of the same heart diseases. These facts profoundly influence prevention and management in clinical practice. Good medical practice demands a more tailored and personal care for each individual patient. In addition, the life-course of women has a few unique phases, related to hormonal changes in pregnancy and after menopause, that also interact with individual risk and the development of co-morbidities. As heart disease is now the number one cause of death in women worldwide, a more specific attention to cardiovascular disease in women is justified.
Most important advances in gender-specific knowledge are related to ischemic heart disease and its traditional and sex-specific risk factors. Diagnostic pathways have changed, coronary angiography is no longer the gold standard that it used to be. Recent guidelines and position papers have paid attention to these new insights, whereas educational programs urgently need to be adapted. The ongoing paradigm shift in cardiology needs to be updated for the clinician in an easy and accessible manner. Other important topics in which sex and gender differences have been elaborated are heart failure, atrial fibrillation, aortic valve disease and its treatment, cardiac rehabilitation, co-morbidities, cardiotoxicity in cancer treatment and neurology. In addition, female-specific risk factors and socio-economic factors are relevant to women’s cardiovascular health. We will invite the best EU experts in this field to contribute to the various chapters.
Manual of Cardiovascular Disease in Women has an educational role for established cardiologists and vascular specialists in training, nurses and other allied professionals. It represents an update on the most recent insights in sex- and gender differences in cardiovascular health with a focus on women’s cardiovascular diseases.
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Angela Maas, MD PhD, is a clinical cardiologist since more than 30 years and has developed a main interest in heart disease in women over the past decades. She established the first outpatient clinic for women in the Netherlands in 2003. She was appointed as professor in cardiology for women at the Radboudumc in Nijmegen in 2012. Her main interests are the early identification of women at increased CV risk and symptom evaluation in women at middle-age. She has received many awards such as by the Dutch Society of female physicians (2010), the Radboud University (2014) and was knighted by the King in 2017. She is currently one of the most influential female doctors in Dutch healthcare and was the 2020/21 Women's representative of the Dutch Government to the United Nations. From May 2022 onwards she primarily dedicates her work to research, educational activities and advisory boards.
Eva Gerdts, MD PhD, is a cardiologist since 1994. Her main interest has been how hypertension contributes to sex differences in common cardiac diseases, including hypertensive heart disease, coronary artery disease, atrial fibrillation and aortic valve stenosis. She has worked as a clinical cardiologist at Haukeland University Hospital since 1997. She was appointed professor of cardiology at the University of Bergen (UiB) in 2006. Based on her work, a dedicated Center for Research on Cardiac Disease in Women, which she chairs, was established at the UiB in 2020. She has extensive international research experience, including as postdoctoral fellow at Weill Cornell Medical Center, New York, USA and as guest professor at Federico II University, Naples, Italy. She has received many awards for her work and is a member of the Norwegian Academy for Science and Letters. She is a Fellow of the European Society of Cardiology and of the American Heart Association - Council on hypertension.
