Review Article

Is Extra Virgin Olive Oil an Ally for Women’s and Men’s Cardiovascular Health?

Table 1

Examples of sex and gender differences in CVD and risk factors.

Diseases or risk factorsSex differencesReferences

Myocardial infarctionWomen are 10 years older than males and have higher mortality in younger ages and have more atypical symptoms. Women have less anatomical obstructive CAD than men; it is estimated a 20% or greater excess of normal or nonobstructive arteries in women vs men[4042]
Heart failureLower incidence in women but the prevalence is similar in both sexes, with diastolic heart failure being more common in women. Lower mortality rate in women than in men[40, 41]
HypertensionLower incidence in premenopausal women[40]
Cardiac hypertrophyPremenopausal women are better protected than men; men have more cardiac hypertrophy[40, 43]
Ischemia-reperfusion injuryStudies evidenced that females have lower ischemia-reperfusion injury[40]
DiabetesHigher increased risk of CVD in women vs men[40]
Endothelial dysfunctionMore frequent in women vs men[44, 45]
HDLHigher levels in women vs men; the difference declines with age[46]
TGHigher increased risk of CVD in women vs men. In women, they increase after menopause[47]
CholLevels rise in menopausal transition period[47]
LDLLevels rise in menopausal transition period[46]
Lp (a)Levels rise in menopausal transition period[46]
SmokingLess women smoke vs men, but smoking has more negative effects on women[48]
Social economicus statusIn women, it is inversely associated with increased risk of CAD, stroke, and CVD. In particular, for CHD, it is associated with lower education[49]
Psychological factorsWomen had higher contributions from psychosocial risk factors (45.2% vs 28.8% in men)[50, 51]
Unique for women
Gestational diabetes, pre-eclampsia, syndrome of polycystic ovaryHigher increased risk of CVD in women[48, 52]
Oral contraceptivesA large cohort study (1.6 million of women, 15 to 49 years old) shows that ethinylestradiol (20 μg or 30 to 40 μg) is associated with an increased risk of MI. The risk is not significantly varied by progestin[53]
OC should not be prescribed for women over the age of 35 years and smokers (American College of Obstetricians and Gynecologists) and should be prescribed with caution in case of CV risk factors such as hypertension, diabetes, and dyslipidemia[54]
Hormone replacement therapyA large cohort study shows that ethinylestradiol is associated with an increased risk of MI that is not significantly changed with progestins[55]