Sex differences in the effects of cardiovascular medications

Cardiovascular disease is the leading cause of death for both women and men worldwide. In Austria, cardiovascular diseases were responsible for 36.9% of all deaths among women and for 31.7% of all deaths among men in 2022. A key preventive measure is the use of medications designed to reduce the risk of future cardiovascular disease. However, women remain underrepresented in clinical trials for cardiovascular medications. Therefore, it is unclear whether these medications have the same effects in women and men. The aim of this project is to determine whether there are sex differences in the effects of cardiovascular medications. Randomised controlled trials are considered the gold standard to evaluate such effects. However, it is unlikely that randomised controlled trials to assess the sex- specific effect of already approved medications will ever be reconducted because such studies are prohibitively expensive and it is often ethically unjustifiable to repeat them. Therefore, it is necessary to apply alternative methods. This project stands out by using Mendelian randomisation, an innovative method that under certain assumptions allows mimicking randomised controlled trials. As part of the project, the efficacy and safety of cardiovascular medications will be examined. The project will focus on lipid-modifying, antihypertensive, and antidiabetic medications and their sex- specific effects on various cardiovascular diseases will be analysed. Additionally, potential side effects will be investigated. Furthermore, the project will assess whether potential sex differences can be explained by biological characteristics or mechanisms, and whether this leads to differences in the optimal dosage of medications. The results of this project are highly relevant as they could promote the development and implementation of sex-specific clinical guidelines and support the inclusion of women in future clinical studies. All these aspects would ultimately have a significant impact on public health by promoting equity in the treatment of cardiovascular disease for women and men.