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Review
. 2023 Sep 5;82(10):1030-1038.
doi: 10.1016/j.jacc.2023.05.070.

Impact of Sex on Cardiovascular Adaptations to Exercise: JACC Review Topic of the Week

Bradley J Petek  1 , Eugene H Chung  2 , Jonathan H Kim  3 , Rachel Lampert  4 , Benjamin D Levine  5 , Dermot Phelan  6 , Alfred Danielian  7 , Peter N Dean  8 , Elizabeth H Dineen  9 , Antonio B Fernandez  10 , Mustafa Husaini  11 , Sheela Krishnan  12 , Ankit B Shah  13 , Katie M Stewart  14 , Meagan M Wasfy  15
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Free article
Review

Impact of Sex on Cardiovascular Adaptations to Exercise: JACC Review Topic of the Week

Bradley J Petek et al. J Am Coll Cardiol. .
Free article

Abstract

Routine exercise leads to cardiovascular adaptations that differ based on sex. Use of cardiac testing to screen athletes has driven research to define how these sex-based adaptations manifest on the electrocardiogram and cardiac imaging. Importantly, sex-based differences in cardiovascular structure and outcomes in athletes often parallel findings in the general population, underscoring the importance of understanding their mechanisms. Substantial gaps exist in the understanding of why cardiovascular adaptations and outcomes related to exercise differ by sex because of underrepresentation of female participants in research. As female sports participation rates have increased dramatically over several decades, it also remains unknown if differences observed in older athletes reflect biological mechanisms vs less lifetime access to sports in females. In this review, we will assess the effect of sex on cardiovascular adaptations and outcomes related to exercise, identify the impact of sex hormones on exercise performance, and highlight key areas for future research.

Keywords: athlete; cardiovascular remodeling; female; physical activity.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Kim has received compensation for his role as team cardiologist for the Atlanta Falcons. Dr Phelan has served as a consultant for Caption Health, Bristol Myers Squibb, and Pfizer. Dr Lampert has received compensation for research support and honoraria from and is on the Advisory Board for Medtronic; has received honoraria and research support from Abbott/St Jude; and has received research support from Boston Scientific. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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