Sex Differences in Pulmonary Hypertension

Clin Chest Med. 2021 Mar;42(1):217-228. doi: 10.1016/j.ccm.2020.10.005. Epub 2021 Jan 13.

Abstract

Pulmonary arterial hypertension (PAH) occurs in women more than men whereas survival in men is worse than in women. In recent years, much research has been carried out to understand these sex differences in PAH. This article discusses clinical and preclinical studies that have investigated the influences of sex, serotonin, obesity, estrogen, estrogen synthesis, and estrogen metabolism on bone morphogenetic protein receptor type II signaling, the pulmonary circulation and right ventricle in both heritable and idiopathic pulmonary hypertension.

Keywords: BMPR2; Estrogens; Obesity; Pulmonary circulation; Pulmonary hypertension; Right ventricle; Serotonin; Sex.

Publication types

  • Review

MeSH terms

  • Bone Morphogenetic Protein Receptors, Type II / physiology*
  • Estrogens / biosynthesis
  • Estrogens / metabolism
  • Female
  • Heart Ventricles / physiopathology*
  • Humans
  • Hypertension, Pulmonary / etiology
  • Hypertension, Pulmonary / genetics
  • Hypertension, Pulmonary / physiopathology*
  • Male
  • Obesity / complications
  • Pulmonary Circulation / physiology*
  • Serotonin / metabolism
  • Sex Characteristics
  • Signal Transduction

Substances

  • Estrogens
  • Serotonin
  • Bone Morphogenetic Protein Receptors, Type II