cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2023-3831WJNNUCcardiovascular-3831Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEW ARTICLESПоловые и гендерные различия в здоровье и болезни. Часть II. Клиническая и медико-социальнаяSex and gender differences in health and disease. Part II. Clinical and medical-socialhttps://orcid.org/0000-0002-4453-8430ДрапкинаО. М.DrapkinaO. M.

д.м.н., профессор, академик РАН, директор.

Москва

Moscow

ODrapkina@gnicpm.ruhttps://orcid.org/0000-0002-0332-7696КимО. Т.KimO. T.

м.н.с. отдела фундаментальных и прикладных аспектов ожирения.

Москва

Moscow

olgakimt06@gmail.comФГБУ "Национальный научно-исследовательский центр терапии и профилактической медицины" Минздрава РоссииNational Research Center for Therapy and Preventive Medicine202308022024221238313831Copyright © Драпкина О.М., Ким О.Т., 20232023Драпкина О.М., Ким О.Т.Drapkina O.M., Kim O.T.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/3831

Важным условием оказания качественной и безопасной медицинской помощи является понимание различий между мужчинами и женщинами в эпидемиологии, патофизиологии, факторах риска, клинической картине заболеваний, реакции на лечение и обращаемости за медицинской помощью. Первая часть обзора была посвящена эволюционным механизмам разницы в продолжительности жизни и потенциальным стратегиям увеличения продолжительности жизни мужчин. Во второй части обзора рассматриваются половые и гендерные различия на примере 3-х групп заболеваний, которые, согласно данным Всемирной организации здравоохранения, являются основными причинами смерти в Европейском регионе, в программировании здоровья и болезней, а также причины гендерного парадокса "здоровье-выживаемость".

An important condition for providing quality and safe care is to understand the differences between men and women in epidemiology, pathophysiology, risk factors, clinical performance of diseases, response to treatment and use of medical care. The first part of the review was devoted to the evolutionary mechanisms of differences in life expectancy and potential strategies for increasing life expectancy in men. The second part of the review examines sex and gender differences using the example of 3 groups of diseases, which, according to the World Health Organization, are the main causes of death in the European Region, in the programming of health and disease, as well as the reasons for the male-female health-survival paradox.

программирование здоровья и болезнейгендерный парадоксполовые и гендерные различиясердечнососудистые заболеванияонкологические заболеванияневрологические заболеванияprogramming of health and diseasegender paradoxsex and gender differencescardiovascular diseasescancerneurological diseasesReferencesMauvais-Jarvis F, Bairey Merz N, Barnes PJ, et al. Sex and gender: modifiers of health, disease, and medicine. Lancet. 2020;396(10250):565-82. doi:10.1016/S0140-6736(20)31561-0.Mauvais-Jarvis F, Bairey Merz N, Barnes PJ, et al. Sex and gender: modifiers of health, disease, and medicine. Lancet. 2020;396(10250):565-82. doi:10.1016/S0140-6736(20)31561-0.Oksuzyan A, Shkolnikova M, Vaupel JW, et al. Sex differences in health and mortality in Moscow and Denmark. Eur J Epidemiol. 2014;29(4):243-52. doi:10.1007/s10654-014-9893-4.Oksuzyan A, Shkolnikova M, Vaupel JW, et al. Sex differences in health and mortality in Moscow and Denmark. Eur J Epidemiol. 2014;29(4):243-52. doi:10.1007/s10654-014-9893-4.Lippi D, Bianucci R, Donell S. Gender medicine: its historical roots. Postgrad Med J. 2020;96(1138):480-6. doi: 10.1136/postgradmedj-2019-137452.Lippi D, Bianucci R, Donell S. Gender medicine: its historical roots. Postgrad Med J. 2020;96(1138):480-6. doi: 10.1136/postgradmedj-2019-137452.Семочкин С. В. Механизмы действия противоопухолевых иммуномодуляторов — от тератогенности к терапии множественной миеломы. Гематология и трансфузиология. 2022;67(2):240-60. doi:10.35754/0234-5730-202267-2-240-260.Semochkin SV. Mechanisms of action of immunomodulatory drugs — from teratogenicity to treatment of multiple myeloma. Russian journal of hematology and transfusiology. 2022;67(2): 240-60. (In Russ.) doi:10.35754/0234-5730-202267-2-240-260.Beery AK, Zucker I. Sex bias in neuroscience and biomedical research. Neurosci Biobehav Rev. 2011;35(3):565-72. doi:10.1016/j.neubiorev.2010.07.002.Beery AK, Zucker I. Sex bias in neuroscience and biomedical research. Neurosci Biobehav Rev. 2011;35(3):565-72. doi:10.1016/j.neubiorev.2010.07.002.Красняк Э. В., Бондарев К. В. Прошлое, настоящее и будущее гендерной медицины в России и мире. Профилактическая медицина. 2022; 25(10):84-90. doi:10.17116/profmed20222510184.Krasniak EV, Bondarev KV. Past, present and future of gender medicine in Russia and worldwide. Profilakticheskaya Meditsina. 2022;25(10):84-90. (In Russ.) doi:10.17116/profmed20222510184.Ramirez FD, Motazedian P, Jung RG, et al. Sex Bias Is Increasingly Prevalent in Preclinical Cardiovascular Research: Implications for Translational Medicine and Health Equity for Women: A Systematic Assessment of Leading Cardiovascular Journals Over a 10-Year Period. Circulation. 2017;135(6):625-6. doi:10.1161/CIRCULATIONAHA.116.026668.Ramirez FD, Motazedian P, Jung RG, et al. Sex Bias Is Increasingly Prevalent in Preclinical Cardiovascular Research: Implications for Translational Medicine and Health Equity for Women: A Systematic Assessment of Leading Cardiovascular Journals Over a 10-Year Period. Circulation. 2017;135(6):625-6. doi:10.1161/CIRCULATIONAHA.116.026668.Kim JY, Min K, Paik HY, et al. Sex omission and male bias are still widespread in cell experiments. Am J Physiol Cell Physiol. 2021;320(5):C742-9. doi:10.1152/ajpcell.00358.2020.Kim JY, Min K, Paik HY, et al. Sex omission and male bias are still widespread in cell experiments. Am J Physiol Cell Physiol. 2021;320(5):C742-9. doi:10.1152/ajpcell.00358.2020.Zucker I, Prendergast BJ. Sex differences in pharmacokinetics predict adverse drug reactions in women. Biol Sex Differ. 2020;11(1):32. doi:10.1186/s13293-020-00308-5.Zucker I, Prendergast BJ. Sex differences in pharmacokinetics predict adverse drug reactions in women. Biol Sex Differ. 2020;11(1):32. doi:10.1186/s13293-020-00308-5.Watson S, Caster O, Rochon PA, et al. Reported adverse drug reactions in women and men: Aggregated evidence from globally collected individual case reports during half a century. EClinicalMedicine. 2019;17:100188. doi:10.1016/j.eclinm.2019.10.001.Watson S, Caster O, Rochon PA, et al. Reported adverse drug reactions in women and men: Aggregated evidence from globally collected individual case reports during half a century. EClinicalMedicine. 2019;17:100188. doi:10.1016/j.eclinm.2019.10.001.Doblhammer G, Hoffmann R. Gender differences in trajectories of health limitations and subsequent mortality. A study based on the German Socioeconomic Panel 1995-2001 with a mortality followup 2002-2005. J Gerontol B Psychol Sci Soc Sci. 2010;65(4): 482-91. doi:10.1093/geronb/gbp051.Doblhammer G, Hoffmann R. Gender differences in trajectories of health limitations and subsequent mortality. A study based on the German Socioeconomic Panel 1995-2001 with a mortality followup 2002-2005. J Gerontol B Psychol Sci Soc Sci. 2010;65(4): 482-91. doi:10.1093/geronb/gbp051.Rochon PA, Petrovic M, Cherubini A, et al. Polypharmacy, inappropriate prescribing, and deprescribing in older people: through a sex and gender lens. Lancet Healthy Longev. 2021;2(5):e290300. doi:10.1016/S2666-7568(21)00054-4.Rochon PA, Petrovic M, Cherubini A, et al. Polypharmacy, inappropriate prescribing, and deprescribing in older people: through a sex and gender lens. Lancet Healthy Longev. 2021;2(5):e290300. doi:10.1016/S2666-7568(21)00054-4.Kulagina NV. Masculine Standard Directions of Modern Men of Different Ages. Psychologist. 2016;(1):70-9. (In Russ.) Кулагина Н. В. Маскулинные нормативные установки современных мужчин разного возраста. Психолог. 2016;(1):70-9. doi:10.7256/2409-8701.2016.1.18046.Kulagina NV. Masculine Standard Directions of Modern Men of Different Ages. Psychologist. 2016;(1):70-9. (In Russ.) doi:10.7256/2409-8701.2016.1.18046.Брюн Е. А. Депрессия, тревожные расстройства и антисоциальное расстройство личности как факторы риска или последствие алкоголизма и наркомании: гендерные аспекты. Наркология. 2018;17(11):74-85. doi:10.25557/1682-8313.2018.11.74-85.Bryun EA, Polunina AG. Depression, anxiety disorders and antisocial personality disorder as risk factors or consequences of alcoholism and drug addiction: gender aspects. Narkologia [Narcology]. 2018;17(11):74-85. (In Russ.) doi:10.25557/1682-8313.2018.11.74-85.Sazhenova EA. Evolutionary Aspects of Genomic Imprinting. Molecular Biology. 2021;55(1):3-19. (In Russ.) Саженова Е. А. Эволюционные аспекты геномного импринтинга. Молекулярная биология. 2021;55(1):3-19. doi:10.31857/S0026898420060105.Sazhenova EA. Evolutionary Aspects of Genomic Imprinting. Molecular Biology. 2021;55(1):3-19. (In Russ.) doi:10.31857/S0026898420060105.Moore GE, Ishida M, Demetriou C, et al. The role and interaction of imprinted genes in human fetal growth. Philos Trans R Soc Lond B Biol Sci. 2015;370(1663):20140074. doi:10.1098/rstb.2014.0074.Moore GE, Ishida M, Demetriou C, et al. The role and interaction of imprinted genes in human fetal growth. Philos Trans R Soc Lond B Biol Sci. 2015;370(1663):20140074. doi:10.1098/rstb.2014.0074.Alur P.Sex Differences in Nutrition, Growth, and Metabolism in Preterm Infants. Front Pediatr. 2019;7:22. doi:10.3389/fped.2019.00022.Alur P.Sex Differences in Nutrition, Growth, and Metabolism in Preterm Infants. Front Pediatr. 2019;7:22. doi:10.3389/fped.2019.00022.Broere-Brown ZA, Adank MC, Benschop L, et al. Fetal sex and maternal pregnancy outcomes: a systematic review and metaanalysis. Biol Sex Differ. 2020;11(1):26. doi:10.1186/s13293-02000299-3.Broere-Brown ZA, Adank MC, Benschop L, et al. Fetal sex and maternal pregnancy outcomes: a systematic review and metaanalysis. Biol Sex Differ. 2020;11(1):26. doi:10.1186/s13293-02000299-3.Sun T, Gonzalez TL, Deng N, et al. Sexually Dimorphic Crosstalk at the Maternal-Fetal Interface. J Clin Endocrinol Metab. 2020; 105(12): e4831-47. doi:10.1210/clinem/dgaa503.Sun T, Gonzalez TL, Deng N, et al. Sexually Dimorphic Crosstalk at the Maternal-Fetal Interface. J Clin Endocrinol Metab. 2020; 105(12): e4831-47. doi:10.1210/clinem/dgaa503.Goldenberg RL, Andrews WW, Faye-Petersen OM, et al. The Alabama Preterm Birth Study: intrauterine infection and placental histologic findings in preterm births of males and females less than 32 weeks. Am J Obstet Gynecol. 2006;195(6):1533-7. doi:10.1016/j.ajog.2006.05.023.Goldenberg RL, Andrews WW, Faye-Petersen OM, et al. The Alabama Preterm Birth Study: intrauterine infection and placental histologic findings in preterm births of males and females less than 32 weeks. Am J Obstet Gynecol. 2006;195(6):1533-7. doi:10.1016/j.ajog.2006.05.023.Baines KJ, West RC. Sex differences in innate and adaptive immunity impact fetal, placental, and maternal health. Biol Reprod. 2023;ioad072. doi:10.1093/biolre/ioad072.Baines KJ, West RC. Sex differences in innate and adaptive immunity impact fetal, placental, and maternal health. Biol Reprod. 2023;ioad072. doi:10.1093/biolre/ioad072.Zeitlin J, Saurel-Cubizolles MJ, De Mouzon J, et al. Fetal sex and preterm birth: are males at greater risk? Hum Reprod. 2002; 17(10):2762-8. doi:10.1093/humrep/17.10.2762.Zeitlin J, Saurel-Cubizolles MJ, De Mouzon J, et al. Fetal sex and preterm birth: are males at greater risk? Hum Reprod. 2002; 17(10):2762-8. doi:10.1093/humrep/17.10.2762.Mondal D, Galloway TS, Bailey TC, et al. Elevated risk of stillbirth in males: systematic review and meta-analysis of more than 30 million births. BMC Med. 2014;12:220. doi:10.1186/s12916-0140220-4.Mondal D, Galloway TS, Bailey TC, et al. Elevated risk of stillbirth in males: systematic review and meta-analysis of more than 30 million births. BMC Med. 2014;12:220. doi:10.1186/s12916-0140220-4.Mohamed MA, Aly H. Impact of race on male predisposition to birth asphyxia. J Perinatol. 2014;34(6):449-52. doi:10.1038/jp.2014.27.Mohamed MA, Aly H. Impact of race on male predisposition to birth asphyxia. J Perinatol. 2014;34(6):449-52. doi:10.1038/jp.2014.27.Peacock JL, Marston L, Marlow N, et al. Neonatal and infant outcome in boys and girls born very prematurely. Pediatr Res. 2012; 71(3):305-10. doi:10.1038/pr.2011.50.Peacock JL, Marston L, Marlow N, et al. Neonatal and infant outcome in boys and girls born very prematurely. Pediatr Res. 2012; 71(3):305-10. doi:10.1038/pr.2011.50.O'Driscoll DN, McGovern M, Greene CM, et al. Gender disparities in preterm neonatal outcomes. Acta Paediatr. 2018;107(9):14949. doi:10.1111/apa.14390.O'Driscoll DN, McGovern M, Greene CM, et al. Gender disparities in preterm neonatal outcomes. Acta Paediatr. 2018;107(9):14949. doi:10.1111/apa.14390.Хворостухина Н. Ф., Колесникова Е. А., Степанова Н. Н. и др. Влияние пола плода на течение беременности и перинатальные исходы при преждевременных родах. Вопросы гинекологии, акушерства и перинатологии. 2021;20(6):44-50. doi:10.20953/1726-1678-2021-6-44-50.Khvorostukhina NF, Kolesnikova EA, Stepanova NN, et al. Effect of fetal sex on the course of pregnancy and perinatal outcomes in preterm birth. Vopr ginekol akus perinatol. (Gynecology, Obstetrics and Perinatology). 2021;20(6):44-50. (In Russ.) doi:10.20953/1726-1678-2021-6-44-50.Steen EE, Källén K, Maršál K, et al. Impact of sex on perinatal mortality and morbidity in twins. J Perinat Med. 2014;42(2):22531. doi:10.1515/jpm-2013-0147.Steen EE, Källén K, Maršál K, et al. Impact of sex on perinatal mortality and morbidity in twins. J Perinat Med. 2014;42(2):22531. doi:10.1515/jpm-2013-0147.Melamed N, Yogev Y, Glezerman M. Effect of fetal sex on pregnancy outcome in twin pregnancies. Obstet Gynecol. 2009; 114(5):1085-92. doi:10.1097/AOG.0b013e3181bd8874.Melamed N, Yogev Y, Glezerman M. Effect of fetal sex on pregnancy outcome in twin pregnancies. Obstet Gynecol. 2009; 114(5):1085-92. doi:10.1097/AOG.0b013e3181bd8874.Sinha A, Madden J, Ross-Degnan D, et al. Reduced risk of neonatal respiratory infections among breastfed girls but not boys. Pediatrics. 2003;112(4):e303. doi:10.1542/peds.112.4.e303.Sinha A, Madden J, Ross-Degnan D, et al. Reduced risk of neonatal respiratory infections among breastfed girls but not boys. Pediatrics. 2003;112(4):e303. doi:10.1542/peds.112.4.e303.Чубаров Т. В., Бессонова А. В., Жданова О. А. и др. Факторы риска развития ожирения в различные периоды детства. Ожирение и метаболизм. 2021;18(2):163-8. doi:10.14341/omet12756.Chubarov TV, Bessonova AV, Zhdanova OA, et al. Risk Factors for Obesity Development in Different Periods of Childhood. Obesity and metabolism. 2021;18(2):163-8. (In Russ.) doi:10.14341/omet12756.Gabory A, Roseboom TJ, Moore T, et al. Placental contribution to the origins of sexual dimorphism in health and diseases: sex chromosomes and epigenetics. Biol Sex Differ. 2013;4(1):5. doi:10.1186/2042-6410-4-5.Gabory A, Roseboom TJ, Moore T, et al. Placental contribution to the origins of sexual dimorphism in health and diseases: sex chromosomes and epigenetics. Biol Sex Differ. 2013;4(1):5. doi:10.1186/2042-6410-4-5.Herba CM, Glover V.The Developmental Effects of Prenatal Maternal Stress: Evolutionary Explanations. In: Wazana, A., Székely, E., Oberlander, T.F. (eds) Prenatal Stress and Child Development. Springer, Cham. 2021. doi:10.1007/978-3-030-60159-1_3. ISBN: 978-3-030-60158-4.Herba CM, Glover V.The Developmental Effects of Prenatal Maternal Stress: Evolutionary Explanations. In: Wazana, A., Székely, E., Oberlander, T.F. (eds) Prenatal Stress and Child Development. Springer, Cham. 2021. doi:10.1007/978-3-030-60159-1_3. ISBN: 978-3-030-60158-4.Всемирная организация здравоохранения. Европейское региональное бюро. (2020). Здоровье и благополучие мужчин в Европейском регионе ВОЗ: улучшение здоровья в рамках гендерного подхода. Всемирная организация здравоохранения. Европейское региональное бюро. https://apps.who.int/iris/handle/10665/332322. License: CC BY-NC-SA 3.0 IGO. ISBN: 978 92 890 5661 8.World Health Organization. Regional Office for Europe. (2018). The health and well-being of men in the WHO European Region: better health through a gender approach. World Health Organization. Regional Office for Europe. (In Russ.) https://apps.who.int/iris/handle/10665/332322. License: CC BY-NC-SA 3.0 IGO. ISBN: 978 92 890 5661 8.Шальнова С. А., Максимов С. А., Баланова Ю. А. и др. Приверженность к здоровому образу жизни в российской популяции в зависимости от социально-демографических характеристик населения. Кардиоваскулярная терапия и профилактика. 2020;19(2):2452. doi:10.15829/1728-8800-2020-2452.Shalnova SA, Maksimov SA, Balanova YuA, et al. Adherence to a healthy lifestyle of the Russian population depending on the socio-demographics. Cardiovascular Therapy and Prevention. 2020;19(2):2452. (In Russ.) doi:10.15829/1728-8800-2020-2452.Appelman Y, van Rijn BB, Ten Haaf ME, et al. Sex differences in cardiovascular risk factors and disease prevention. Atherosclerosis. 2015;241(1):211-8. doi:10.1016/j.atherosclerosis.2015.01.027.Appelman Y, van Rijn BB, Ten Haaf ME, et al. Sex differences in cardiovascular risk factors and disease prevention. Atherosclerosis. 2015;241(1):211-8. doi:10.1016/j.atherosclerosis.2015.01.027.Шаповалова Э. Б., Максимов С. А., Артамонова Г. В. Половые и гендерные различия сердечнососудистого риска. Российский кардиологический журнал. 2019;(4):99-104. doi:10.15829/1560-4071-2019-4-99-104.Shapovalova EB, Maksimov SA, Artamonova GV. Gender differences of cardiovascular risk. Russian Journal of Cardiology. 2019;(4):99-104. (In Russ.) doi:10.15829/1560-4071-2019-4-99-104.Fiechter M, Haider A, Bengs S, et al. Sex-dependent association between inflammation, neural stress responses, and impaired myocardial function. Eur J Nucl Med Mol Imaging. 2020;47(8): 2010-5. doi:10.1007/s00259-019-04537-8.Fiechter M, Haider A, Bengs S, et al. Sex-dependent association between inflammation, neural stress responses, and impaired myocardial function. Eur J Nucl Med Mol Imaging. 2020;47(8): 2010-5. doi:10.1007/s00259-019-04537-8.Болдуева С. А., Евдокимов Д. С. Кардиомиопатия такоцубо. Обзор данных литературы: клиническая картина, алгоритм диагностики, лечение, прогноз. Часть II. Российский кардиологический журнал. 2022;27(3S): 4994. doi:10.15829/1560-4071-2022-4994.Boldueva SA, Evdokimov DS. Takotsubo cardiomyopathy. Literature review: clinical performance, diagnostic algorithm, treatment, prognosis. Part II. Russian Journal of Cardiology. 2022;27(3S):4994. (In Russ.) doi:10.15829/1560-4071-2022-4994.Zhernakova DV, Sinha T, Andreu-Sánchez S, et al. Age-dependent sex differences in cardiometabolic risk factors. Nat Cardiovasc Res. 2022;1:844-54. doi:10.1038/s44161-022-00131-8.Zhernakova DV, Sinha T, Andreu-Sánchez S, et al. Age-dependent sex differences in cardiometabolic risk factors. Nat Cardiovasc Res. 2022;1:844-54. doi:10.1038/s44161-022-00131-8.Peters SA, Woodward M. Women's reproductive factors and incident cardiovascular disease in the UK Biobank. Heart. 2018;104(13):1069-75. doi:10.1136/heartjnl-2017-312289.Peters SA, Woodward M. Women's reproductive factors and incident cardiovascular disease in the UK Biobank. Heart. 2018;104(13):1069-75. doi:10.1136/heartjnl-2017-312289.Ерина А. М., Усольцев Д. А., Бояринова М. А. и др. Потребность в назначении гиполипидемической терапии в российской популяции: сравнение шкал SCORE и SCORE2 (по данным исследования ЭССЕ-РФ). Российский кардиологический журнал. 2022;27(5):5006. doi:10.15829/1560-4071-2022-5006.Erina AM, Usoltsev DA, Boyarinova MA, et al. Appointment of lipid-lowering therapy in the Russian population: comparison of SCORE and SCORE2 (according to the ESSE-RF study). Russian Journal of Cardiology. 2022;27(5):5006. (In Russ.) doi:10.15829/1560-4071-2022-5006.Харисова Э. Х., Балеева Л. В., Галеева З. М. и др. Гендерные различия в течении инфаркта миокарда. Неотложная кардиология 2018;(4):35-40. doi:10.25679/EMERGCARDIOLOGY.2019.92.81.004.Kharisova EKh, Baleyeva LV, Galeeva ZM, et al. Gender differences in the course of myocardial infarction. Emergency Cardiology. 2018;(4):35-40. (In Russ.) Харисова Э. Х., Балеева Л. В., Галеева З. М. и др. Гендерные различия в течении инфаркта миокарда. Неотложная кардиология 2018;(4):35-40. doi:10.25679/EMERGCARDIOLOGY.2019.92.81.004.Coventry LL, Finn J, Bremner AP. Sex differences in symptom presentation in acute myocardial infarction: a systematic review and meta-analysis. Heart Lung. 2011;40(6):477-91. doi:10.1016/j.hrtlng.2011.05.001.Coventry LL, Finn J, Bremner AP. Sex differences in symptom presentation in acute myocardial infarction: a systematic review and meta-analysis. Heart Lung. 2011;40(6):477-91. doi:10.1016/j.hrtlng.2011.05.001.Трисветова Е. Л. Коронарная микрососудистая дисфункция: эпидемиология, клиника, диагностика и лечение. Рациональная Фармакотерапия в Кардиологии. 2023;19(2): 186-96. doi:10.20996/1819-6446-2023-04-02.Trisvetova EL. Coronary Microvascular Dysfunction: Epidemiology, Clinical Presentation, Diagnosis and Treatment. Rational Pharmacotherapy in Cardiology. 2023;19(2):186-96. (In Russ.) doi:10.20996/1819-6446-2023-04-02.Herscovici R, Sedlak T, Wei J, et al. Ischemia and No Obstructive Coronary Artery Disease (INOCA): What Is the Risk? J Am Heart Assoc. 2018;7(17):e008868. doi:10.1161/JAHA.118.008868.Herscovici R, Sedlak T, Wei J, et al. Ischemia and No Obstructive Coronary Artery Disease (INOCA): What Is the Risk? J Am Heart Assoc. 2018;7(17):e008868. doi:10.1161/JAHA.118.008868.Подзолков В. И., Брагина А. Е., Подзолкова Н. М. Менопаузальная гормональная терапия и сердечно-сосудистая профилактика: желаемое или действительное? Кардиоваскулярная терапия и профилактика. 2019;18(3):94-106. doi:10.15829/1728-8800-2019-3-94-106.Podzolkov VI, Bragina AE, Podzolkovа NM. Menopausal hormone therapy and heart disease prevention: desired or valid? Cardiovascular Therapy and Prevention. 2019;18(3):94-106. (In Russ.) doi:10.15829/1728-8800-2019-3-94-106.Regitz-Zagrosek V. Sex and Gender Differences in Heart Failure. Int J Heart Fail. 2020;2(3):157-81. doi:10.36628/ijhf.2020.0004.Regitz-Zagrosek V. Sex and Gender Differences in Heart Failure. Int J Heart Fail. 2020;2(3):157-81. doi:10.36628/ijhf.2020.0004.Alam M, Bandeali SJ, Kayani WT, et al. Comparison by metaanalysis of mortality after isolated coronary artery bypass grafting in women versus men. Am J Cardiol. 2013;112(3):309-17. doi:10.1016/j.amjcard.2013.03.034.Alam M, Bandeali SJ, Kayani WT, et al. Comparison by metaanalysis of mortality after isolated coronary artery bypass grafting in women versus men. Am J Cardiol. 2013;112(3):309-17. doi:10.1016/j.amjcard.2013.03.034.White-Williams C, Rossi LP, Bittner VA, et al. American Heart Association Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Council on Epidemiology and Prevention. Addressing Social Determinants of Health in the Care of Patients With Heart Failure: A Scientific Statement From the American Heart Association. Circulation. 2020;141(22):e841-63. doi:10.1161/CIR.0000000000000767.White-Williams C, Rossi LP, Bittner VA, et al. American Heart Association Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Council on Epidemiology and Prevention. Addressing Social Determinants of Health in the Care of Patients With Heart Failure: A Scientific Statement From the American Heart Association. Circulation. 2020;141(22):e841-63. doi:10.1161/CIR.0000000000000767.McMurray JJV, Jackson AM, Lam CSP, et al. Effects of SacubitrilValsartan Versus Valsartan in Women Compared With Men With Heart Failure and Preserved Ejection Fraction: Insights From PARAGON-HF. Circulation. 2020;141(5):338-51. doi:10.1161/CIRCULATIONAHA.119.044491.McMurray JJV, Jackson AM, Lam CSP, et al. Effects of SacubitrilValsartan Versus Valsartan in Women Compared With Men With Heart Failure and Preserved Ejection Fraction: Insights From PARAGON-HF. Circulation. 2020;141(5):338-51. doi:10.1161/CIRCULATIONAHA.119.044491.Vicent L, Ayesta A, Esteban-Fernández A, et al. Sex Influence on the Efficacy and Safety of Sacubitril/Valsartan. Cardiology. 2019;142(2):73-8. doi:10.1159/000498984.Vicent L, Ayesta A, Esteban-Fernández A, et al. Sex Influence on the Efficacy and Safety of Sacubitril/Valsartan. Cardiology. 2019;142(2):73-8. doi:10.1159/000498984.Santema BT, Ouwerkerk W, Tromp J, et al. Identifying optimal doses of heart failure medications in men compared with women: a prospective, observational, cohort study. Lancet. 2019; 394(10205):1254-63. doi:10.1016/S0140-6736(19)31792-1.Santema BT, Ouwerkerk W, Tromp J, et al. Identifying optimal doses of heart failure medications in men compared with women: a prospective, observational, cohort study. Lancet. 2019; 394(10205):1254-63. doi:10.1016/S0140-6736(19)31792-1.Zusterzeel R, Selzman KA, Sanders WE, et al. Cardiac Resynchronization Therapy in Women: US Food and Drug Administration Meta-analysis of Patient-Level Data. JAMA Intern Med. 2014; 174(8):1340-8. doi:10.1001/jamainternmed.2014.2717.Zusterzeel R, Selzman KA, Sanders WE, et al. Cardiac Resynchronization Therapy in Women: US Food and Drug Administration Meta-analysis of Patient-Level Data. JAMA Intern Med. 2014; 174(8):1340-8. doi:10.1001/jamainternmed.2014.2717.EUGenMed Cardiovascular Clinical Study Group; Regitz-Zagrosek V, Oertelt-Prigione S, et al. Gender in cardiovascular diseases: impact on clinical manifestations, management, and outcomes. Eur Heart J. 2016;37(1):24-34. doi:10.1093/eurheartj/ehv598.EUGenMed Cardiovascular Clinical Study Group; Regitz-Zagrosek V, Oertelt-Prigione S, et al. Gender in cardiovascular diseases: impact on clinical manifestations, management, and outcomes. Eur Heart J. 2016;37(1):24-34. doi:10.1093/eurheartj/ehv598.Greenwood BN, Carnahan S, Huang L. Patient-physician gender concordance and increased mortality among female heart attack patients. Proc Natl Acad Sci U S A. 2018;115(34):8569-74. doi:10.1073/pnas.1800097115.Greenwood BN, Carnahan S, Huang L. Patient-physician gender concordance and increased mortality among female heart attack patients. Proc Natl Acad Sci U S A. 2018;115(34):8569-74. doi:10.1073/pnas.1800097115.Bushnell CD, Chaturvedi S, Gage KR, et al. Sex differences in stroke: Challenges and opportunities. J Cereb Blood Flow Metab. 2018;38(12):2179-91. doi:10.1177/0271678X18793324.Bushnell CD, Chaturvedi S, Gage KR, et al. Sex differences in stroke: Challenges and opportunities. J Cereb Blood Flow Metab. 2018;38(12):2179-91. doi:10.1177/0271678X18793324.Бокерия О. Л., Хубулова Л. Н. Женщины с фибрилляцией предсердий. Анналы аритмологии. 2019;16(1):15-21. doi:10.15275/annaritmol.2019.1.2.Bockeria OL, Khubulova LN. Women with atrial fibrillation. Annals of Arrhythmology. 2019;16(1):15-21. (In Russ.) doi:10.15275/annaritmol.2019.1.2.Максимова М. Ю., Айрапетова А. С. Гендерные особенности отдельных факторов риска развития нарушений мозгового кровообращения. Журнал неврологии и психиатрии им. С. С. Корсакова. Спецвыпуски. 2019;119(12 2):58-64.Maksimova MYu, Airapetova AS. Gender differences in stroke risk factors. Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova. 2019;119(12 2):58-64. (In Russ.)Rexrode KM, Madsen TE, Yu AYX, et al. The Impact of Sex and Gender on Stroke. Circ Res. 2022;130(4):512-28. doi:10.1161/CIRCRESAHA.121.319915.Rexrode KM, Madsen TE, Yu AYX, et al. The Impact of Sex and Gender on Stroke. Circ Res. 2022;130(4):512-28. doi:10.1161/CIRCRESAHA.121.319915.Okoth K, Chandan JS, Marshall T, et al. Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review. BMJ. 2020;371:m3502. doi:10.1136/bmj.m3502. Erratum in: BMJ. 2020;371:m3963.Okoth K, Chandan JS, Marshall T, et al. Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review. BMJ. 2020;371:m3502. doi:10.1136/bmj.m3502. Erratum in: BMJ. 2020;371:m3963.Bushnell C, Howard VJ, Lisabeth L, et al. Sex differences in the evaluation and treatment of acute ischaemic stroke. Lancet Neurol. 2018;17(7):641-50. doi:10.1016/S1474-4422(18)30201-1.Bushnell C, Howard VJ, Lisabeth L, et al. Sex differences in the evaluation and treatment of acute ischaemic stroke. Lancet Neurol. 2018;17(7):641-50. doi:10.1016/S1474-4422(18)30201-1.Gdovinova Z, Kremer C, Lorenzano S, et al. Aspirin for Primary Stroke Prevention; Evidence for a Differential Effect in Men and Women. Front Neurol. 2022;13:856239. doi:10.3389/fneur.2022.856239.Gdovinova Z, Kremer C, Lorenzano S, et al. Aspirin for Primary Stroke Prevention; Evidence for a Differential Effect in Men and Women. Front Neurol. 2022;13:856239. doi:10.3389/fneur.2022.856239.Strong B, Lisabeth LD, Reeves M. Sex differences in IV thrombolysis treatment for acute ischemic stroke: A systematic review and meta-analysis. Neurology. 2020;95(1):e11-e22. doi:10.1212/WNL.0000000000009733.Strong B, Lisabeth LD, Reeves M. Sex differences in IV thrombolysis treatment for acute ischemic stroke: A systematic review and meta-analysis. Neurology. 2020;95(1):e11-e22. doi:10.1212/WNL.0000000000009733.Ouyang M, Shajahan S, Liu X, et al. Sex differences in the utilization and outcomes of endovascular treatment after acute ischemic stroke: A systematic review and meta-analysis. Front Glob Womens Health. 2023;3:1032592. doi:10.3389/fgwh.2022.1032592.Ouyang M, Shajahan S, Liu X, et al. Sex differences in the utilization and outcomes of endovascular treatment after acute ischemic stroke: A systematic review and meta-analysis. Front Glob Womens Health. 2023;3:1032592. doi:10.3389/fgwh.2022.1032592.Rubin JB, Lagas JS, Broestl L, et al. Sex differences in cancer mechanisms. Biol Sex Differ. 2020;11(1):17. doi:10.1186/s13293020-00291-x.Rubin JB, Lagas JS, Broestl L, et al. Sex differences in cancer mechanisms. Biol Sex Differ. 2020;11(1):17. doi:10.1186/s13293020-00291-x.Clocchiatti A, Cora E, Zhang Y, et al. Sexual dimorphism in cancer. Nat Rev Cancer. 2016;16(5):330-9. doi:10.1038/nrc.2016.30.Clocchiatti A, Cora E, Zhang Y, et al. Sexual dimorphism in cancer. Nat Rev Cancer. 2016;16(5):330-9. doi:10.1038/nrc.2016.30.Rubin JB. The spectrum of sex differences in cancer. Trends Cancer. 2022;8(4):303-15. doi:10.1016/j.trecan.2022.01.013.Rubin JB. The spectrum of sex differences in cancer. Trends Cancer. 2022;8(4):303-15. doi:10.1016/j.trecan.2022.01.013.Barberio AM, Alareeki A, Viner B, et al. Central body fatness is a stronger predictor of cancer risk than overall body size. Nat Commun. 2019;10(1):383. doi:10.1038/s41467-018-08159-w.Barberio AM, Alareeki A, Viner B, et al. Central body fatness is a stronger predictor of cancer risk than overall body size. Nat Commun. 2019;10(1):383. doi:10.1038/s41467-018-08159-w.Podolskiy DI, Lobanov AV, Kryukov GV, et al. Analysis of cancer genomes reveals basic features of human aging and its role in cancer development. Nat Commun. 2016;7:12157. doi:10.1038/ncomms12157.Podolskiy DI, Lobanov AV, Kryukov GV, et al. Analysis of cancer genomes reveals basic features of human aging and its role in cancer development. Nat Commun. 2016;7:12157. doi:10.1038/ncomms12157.Williams LA, Richardson M, Marcotte EL, et al. Sex ratio among childhood cancers by single year of age. Pediatr Blood Cancer. 2019;66(6):e27620. doi:10.1002/pbc.27620.Williams LA, Richardson M, Marcotte EL, et al. Sex ratio among childhood cancers by single year of age. Pediatr Blood Cancer. 2019;66(6):e27620. doi:10.1002/pbc.27620.Klein SL, Flanagan KL. Sex differences in immune responses. Nat Rev Immunol. 2016;16(10):626-38. doi:10.1038/nri.2016.90.Klein SL, Flanagan KL. Sex differences in immune responses. Nat Rev Immunol. 2016;16(10):626-38. doi:10.1038/nri.2016.90.Dunford A, Weinstock DM, Savova V, et al. Tumor-suppressor genes that escape from X-inactivation contribute to cancer sex bias. Nat Genet. 2017;49(1):10-6. doi:10.1038/ng.3726.Dunford A, Weinstock DM, Savova V, et al. Tumor-suppressor genes that escape from X-inactivation contribute to cancer sex bias. Nat Genet. 2017;49(1):10-6. doi:10.1038/ng.3726.Özdemir BC, Gerard CL, Espinosa da Silva C. Sex and Gender Differences in Anticancer Treatment Toxicity: A Call for Revisiting Drug Dosing in Oncology. Endocrinology. 2022;163(6):bqac058. doi:10.1210/endocr/bqac058.Özdemir BC, Gerard CL, Espinosa da Silva C. Sex and Gender Differences in Anticancer Treatment Toxicity: A Call for Revisiting Drug Dosing in Oncology. Endocrinology. 2022;163(6):bqac058. doi:10.1210/endocr/bqac058.Ye Y, Jing Y, Li L, et al. Sex-associated molecular differences for cancer immunotherapy. Nat Commun. 2020;11(1):1779. doi:10.1038/s41467-020-15679-x.Ye Y, Jing Y, Li L, et al. Sex-associated molecular differences for cancer immunotherapy. Nat Commun. 2020;11(1):1779. doi:10.1038/s41467-020-15679-x.Li X, Feng X, Sun X, et al. Global, regional, and national burden of Alzheimer's disease and other dementias, 1990-2019. Front Aging Neurosci. 2022;14:937486. doi:10.3389/fnagi.2022.937486.Li X, Feng X, Sun X, et al. Global, regional, and national burden of Alzheimer's disease and other dementias, 1990-2019. Front Aging Neurosci. 2022;14:937486. doi:10.3389/fnagi.2022.937486.Малашенкова И. К., Крынский С. А., Мамошина М. В. и др. Полиморфизм гена АРОЕ: влияние аллеля APOE4 на системное воспаление и его роль в патогенезе болезни Альцгеймера. Медицинская иммунология. 2018;20(3):303-12. doi:10.15789/1563-0625-2018-3-303-312.Malashenkova IK, Krynskiy SA, Mamoshina MV, et al. APOE gene polymorphism: the impact of APOE4 allele on systemic inflammation and its role in the pathogenesis of Alzheimer’s disease. Medical Immunology (Russia). 2018;20(3):303-12. (In Russ.) doi:10.15789/1563-0625-2018-3-303-312.Riedel BC, Thompson PM, Brinton RD. Age, APOE and sex: Triad of risk of Alzheimer's disease. J Steroid Biochem Mol Biol. 2016;160:134-47. doi:10.1016/j.jsbmb.2016.03.012.Riedel BC, Thompson PM, Brinton RD. Age, APOE and sex: Triad of risk of Alzheimer's disease. J Steroid Biochem Mol Biol. 2016;160:134-47. doi:10.1016/j.jsbmb.2016.03.012.Rahman A, Jackson H, Hristov H, et al. Sex and Gender Driven Modifiers of Alzheimer's: The Role for Estrogenic Control Across Age, Race, Medical, and Lifestyle Risks. Front Aging Neurosci. 2019;11:315. doi:10.3389/fnagi.2019.00315.Rahman A, Jackson H, Hristov H, et al. Sex and Gender Driven Modifiers of Alzheimer's: The Role for Estrogenic Control Across Age, Race, Medical, and Lifestyle Risks. Front Aging Neurosci. 2019;11:315. doi:10.3389/fnagi.2019.00315.Nebel RA, Aggarwal NT, Barnes LL, et al. Understanding the impact of sex and gender in Alzheimer's disease: A call to action. Alzheimers Dement. 2018;14(9):1171-83. doi:10.1016/j.jalz.2018.04.008.Nebel RA, Aggarwal NT, Barnes LL, et al. Understanding the impact of sex and gender in Alzheimer's disease: A call to action. Alzheimers Dement. 2018;14(9):1171-83. doi:10.1016/j.jalz.2018.04.008.Brinton RD, Yao J, Yin F, et al. Perimenopause as a neurological transition state. Nat Rev Endocrinol. 2015;11(7):393-405. doi:10.1038/nrendo.2015.82.Brinton RD, Yao J, Yin F, et al. Perimenopause as a neurological transition state. Nat Rev Endocrinol. 2015;11(7):393-405. doi:10.1038/nrendo.2015.82.Ma M, Dorstyn D, Ward L, et al. Alzheimers' disease and caregiving: a meta-analytic review comparing the mental health of primary carers to controls. Aging Ment Health. 2018;22(11):1395-405. doi:10.1080/13607863.2017.1370689.Ma M, Dorstyn D, Ward L, et al. Alzheimers' disease and caregiving: a meta-analytic review comparing the mental health of primary carers to controls. Aging Ment Health. 2018;22(11):1395-405. doi:10.1080/13607863.2017.1370689.Eikelboom WS, Pan M, Ossenkoppele R, et al. Sex differences in neuropsychiatric symptoms in Alzheimer's disease dementia: a meta-analysis. Alzheimers Res Ther. 2022;14(1):48. doi:10.1186/s13195-022-00991-z.Eikelboom WS, Pan M, Ossenkoppele R, et al. Sex differences in neuropsychiatric symptoms in Alzheimer's disease dementia: a meta-analysis. Alzheimers Res Ther. 2022;14(1):48. doi:10.1186/s13195-022-00991-z.Canevelli M, Quarata F, Remiddi F, et al. Sex and gender differences in the treatment of Alzheimer's disease: A systematic review of randomized controlled trials. Pharmacol Res. 2017; 115:218-23. doi:10.1016/j.phrs.2016.11.035.Canevelli M, Quarata F, Remiddi F, et al. Sex and gender differences in the treatment of Alzheimer's disease: A systematic review of randomized controlled trials. Pharmacol Res. 2017; 115:218-23. doi:10.1016/j.phrs.2016.11.035.Martinkova J, Quevenco FC, Karcher H, et al. Proportion of Women and Reporting of Outcomes by Sex in Clinical Trials for Alzheimer Disease: A Systematic Review and Meta-analysis. JAMA Netw Open. 2021;4(9):e2124124. doi:10.1001/jamanetworkopen.2021.24124.Martinkova J, Quevenco FC, Karcher H, et al. Proportion of Women and Reporting of Outcomes by Sex in Clinical Trials for Alzheimer Disease: A Systematic Review and Meta-analysis. JAMA Netw Open. 2021;4(9):e2124124. doi:10.1001/jamanetworkopen.2021.24124.

The authors declare that there are no conflicts of interest present.