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European Heart Journal Advance Access published online on July 4, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi397
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European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received April 11, 2005
Revised June 2, 2005
Accepted June 8, 2005

Review

Female-specific aspects in the pharmacotherapy of chronic cardiovascular diseases

Nicoline Jochmann 1, Karl Stangl 1, Edeltraut Garbe 1, Gert Baumann 1, and Verena Stangl 1*

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

* To whom correspondence should be addressed.
Verena Stangl, E-mail: verena.stangl{at}charite.de


  Abstract

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.

Keywords: Gender; Women; Cardiovascular; Therapy; Pharmacokinetics; Drugs.
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