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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Sex and Gender in Cardiovascular Medicine
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1374765
This article is part of the Research Topic Sex-Specific Risk Factors and Cardiovascular Disease Risk in Women View all 3 articles

Differences in cardiovascular risk factors associated with sex and gender identity, but not gender expression, in young, healthy cisgender adults.

Provisionally accepted
Jennifer Williams Jennifer Williams 1Elise Wiley Elise Wiley 1Jem L. Cheng Jem L. Cheng 1Jenna Stone Jenna Stone 1William Bostad William Bostad 1Joshua M. Cherubini Joshua M. Cherubini 1Martin Gibala Martin Gibala 1Ada Tang Ada Tang 1Maureen J. MacDonald Maureen J. MacDonald 2*
  • 1 McMaster University, Hamilton, Ontario, Canada
  • 2 Kinesiology, McMaster University, Hamilton, Ontario, Canada

The final, formatted version of the article will be published soon.

    Background: Sex-differences exist in cardiovascular disease risk factors including elevated blood pressure and arterial stiffness, and decreased endothelial function in males compared to females. Feminine gender expression may be associated with elevated risk of acute coronary syndrome. However, no study has investigated the associations between sex, gender identity, and gender expression and cardiovascular disease risk factors in young adults. Methods: One hundred and thirty participants (22±3y) underwent assessments of hemodynamics, arterial stiffness (pulse wave velocity;PWV), and brachial artery endothelial function (flow mediated dilation; %FMD). Participants completed a questionnaire capturing sex category (50 male/80 female), gender identity category (49 men/79 women/2 non-binary) and aspects of gender expression assessed by the Bem Sex Role Inventory-30 (39 androgynous/33 feminine/29 masculine/29 undifferentiated). Sex/gender identity category groups were compared using unpaired t-tests and gender expression groups compared using one-way ANOVAs. Results: Resting systolic and mean arterial pressure (p<0.01) were elevated in males vs. females. Central PWV was elevated in males (median[interquartile range]: 6.4[1.8] vs. 5.8[2.2] m/s, p=0.02); however, leg and arm PWV were not different between sexes. %FMD was elevated in males vs. females, after accounting for a larger baseline artery diameter in males (8.8±3.3% vs. 7.2±3.1%, p=0.02); since the majority of participants were cisgender, the same results were found examining gender identity (men vs. women). There were no differences across gender expression groups (p>0.05). Conclusions: Sex/gender identity category, but not gender expression, influence cardiovascular risk factors (blood pressure, arterial stiffness, endothelial function) in cisgender adults; further research is needed in gender-diverse populations.

    Keywords: Frontiers in Cardiovascular Medicine: Sex and Gender in Cardiovascular cardiovascular health, sex-differences, sex-and gender-based analysis, Flow mediated dilation, pulse wave velocity

    Received: 22 Jan 2024; Accepted: 05 Aug 2024.

    Copyright: © 2024 Williams, Wiley, Cheng, Stone, Bostad, Cherubini, Gibala, Tang and MacDonald. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Maureen J. MacDonald, Kinesiology, McMaster University, Hamilton, L8S 4K1, Ontario, Canada

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