Vascular Dysfunction in Women

Vascular dysfunction may arise when blood vessel function is impaired by alterations in the underlying cellular functions and responses to stimuli, changes in vascular composition, or damage. Vascular stiffness—in which compliance and elasticity of vessels become compromised—is a significant contributing factor to the development and adverse outcomes of cardiovascular diseases, including hypertension, atherosclerosis and ischemic heart disease. Growing evidence indicates that the development and impact of vascular stiffness is different in women versus men. While women have frequently been excluded from clinical studies of cardiovascular disease in the past, resulting in under-reporting and a lack of clarity of the disease burden faced by women, recent work has sought to address this major shortcoming, and has led to the identification of important sex-associated differences in cardiovascular disease risk, treatment and outcomes. In this chapter, we examine factors that contribute to vascular stiffness and dysfunction, with a focus on the differences between women and men, and consideration of how different life stresses impact women in unique ways.