Sex Differences in Atherosclerotic Cardiovascular Disease Risk in Obstructive Sleep Apnea.
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing mechanistic and clinical literature without systematic review methodology
PubMed 40498397 · doi:10.1007/s11883-025-01311-0
What was done
This was a narrative review examining obstructive sleep apnea (OSA) and its associated atherosclerotic cardiovascular disease (ASCVD) risk, focusing on emerging evidence of sex differences in clinical outcomes and underlying pathophysiological mechanisms.
What was found
No numerical estimates or effect sizes were reported in the abstract. Compared with males who have OSA, females with OSA were reported to have a greater risk of hypertension, higher carotid intima-media thickness, elevated cardiac enzymes, and worse outcomes after ischemic cardiovascular events. These disparities were described as paralleling sex differences in nocturnal hypoxemia, immune cell activity, inflammation, and endothelial dysfunction, frequently co-occurring with low estrogen states.
Why it matters
Recognizing that OSA may confer a higher cardiovascular risk profile in women helps direct clinical attention to sex-specific risk stratification and the potential role of hormonal status in cardiovascular outcomes.
Limits
As a narrative review, it lacks systematic search parameters, standardized study selection, and pooled quantitative data. The abstract provides no primary sample sizes or numerical statistics. As noted by the authors, available data do not yet establish whether the observed sex-specific associations reflect true causal pathways or co-occurring epiphenomena.