Abstract

Well-established cardio-metabolic and sex-specific risk factors impact vascular health across a woman's lifespan and modulate lifelong risk for cardiovascular disease (CVD), which remains the number one killer of women worldwide. CVD remains under-studied and under-recognized in women. In this brief review, we describe the process of vascular aging, highlighting the impact of biological female sex and female sex hormones on arterial stiffening and endothelial dysfunction. We summarize the vasculo-protective effects of estrogen in premenopausal women, and explore the role of the menopausal transition and the autonomic nervous system on accelerated vascular aging seen in older women. Lastly, we will review the vascular impact of female-specific conditions, including polycystic ovarian syndrome and adverse pregnancy outcomes, such as preeclampsia.

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