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European Heart Journal Advance Access originally published online on July 4, 2005
European Heart Journal 2005 26(16):1585-1595; doi:10.1093/eurheartj/ehi397
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org

Female-specific aspects in the pharmacotherapy of chronic cardiovascular diseases

Nicoline Jochmann, Karl Stangl, Edeltraut Garbe, Gert Baumann and Verena Stangl*

Medizinische Klinik mit Schwerpunkt Kardiologie, Angiologie, Pneumologie, Institut für Klinische Pharmakologie, Universitätsmedizin Berlin, Charité Campus Mitte, Schumannstr. 20/21, D–10117 Berlin, Germany

Received 11 April 2005; revised 2 June 2005; accepted 8 June 2005; online publish-ahead-of-print 4 July 2005.

* Corresponding author. Tel: +49 030 450 513 153; fax: +49 030 450 513 932. E-mail address: verena.stangl{at}charite.de

See page 1571 for the editorial comment on this article (doi:10.1093/eurheartj/ehi428)

Differences in pharmacokinetics, pharmacodynamics, and physiology contribute to the phenomenon that women and men frequently respond differently to cardiovascular drugs. Hormonal influences, in addition, can play an important role: for example, the menstrual cycle, menopause, and pregnancy—as a result of fluctuations in concentrations of sexual steroids, and of changes in total body water—can be associated with gender-specific differences in the plasma levels of cardiovascular drugs. Clinical relevance accordingly results, especially for substances with a narrow therapeutic margin. This review treats the most important pharmacodynamic gender-relevant differences in this context, and surveys available evidence on the benefits of therapy of chronic cardiovascular diseases in women. On the whole, the study situation for women is appreciably less favourable than for men: owing to the fact that women are under-represented in most studies, and that few gender-specific analyses have been conducted.

Key Words: Gender • Women • Cardiovascular • Therapy • Pharmacokinetics • Drugs


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