Cardio-rheumatology - the cardiovascular, pharmacological, and surgical risks associated with rheumatological diseases in women

Sep 30, 2026

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Cardiovascular disease (CVD) remains the leading cause of death worldwide, with women facing heightened risk. Among women, those with rheumatic diseases (RDs) represent an exceptionally vulnerable group, given that women comprise about 80% of all RDs, which include autoimmune and autoinflammatory conditions causing chronic inflammation and tissue pathology. Increased CVD risk in women with RD is likely mediated by RD-related mechanisms and by pharmacological factors that induce CVD, alongside currently unidentified pathways. This paper reviews CVD risks in RD patients, sex disparities in RD and CVD care, and current therapeutic and interventional options, aiming to guide patients and clinicians and improve outcomes for women.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages22

Reading Time55 min

AccessFree to download

Abstract

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Author Manuscript Author Manuscript Author Manuscript Author Manuscript | | HHS Public Access
Author manuscript
Can J Physiol Pharmacol. Author manuscript; available in PMC 2026 January 09. | | --- | --- | Published in final edited form as: Can J Physiol Pharmacol. 2024 September 01; 102(9): 511–522. doi:10.1139/cjpp-2023-0420 . Cardio-rheumatology: the cardiovascular, pharmacological, and surgical risks associated with rheumatological diseases in women Samantha Le Sommera, Maria I. Kontaridisa,b,c a Department of Biomedical Research and Translational Medicine, Masonic Medical Research Institute, Utica, NY, USA b Department of Medicine, Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA, USA c Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA, USA Abstract Cardiovascular disease (CVD) remains the number one cause of death worldwide. Women are at increased risk of death from CVD, but the mechanisms for how and why this occurs remain elusive. One subset of women who are exceptionally vulnerable to CVD are those with rheumatic diseases (RDs) . Indeed, women account for 80% of all RDs, disorders that encompass a broad range of autoimmune and autoinflammatory diseases that lead to chronic inflammation and pathology. The clear association of increased CVD risk in women with RD is thought to be mediated by a number offactors, including RD pathology itself, pharmacological induction of CVD, and/or as yet unidentified mechanisms. As such, elucidation of the causes and treatments of these pathologies has given rise to a new subspecialty of cardiology: cardio-rheumatology. Here, we review and discuss the CVD risks in patients with RDs, the associated sex disparities in RD and CVD care, as well as the current therapeutic and interventional options available to specifically help women with RDs. We hope this discussion will provide guidance and support to patients, as well as to cardio-rheumatologists, as these groups are the most uniquely positioned to radically improve CVD care in these individuals. Moreover, we are hopeful this discussion may lead to better, more efficacious approaches to treating these disorders in women in the near future. This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. Corresponding author: Maria I. Kontaridis ([mkontaridis@mmri.edu](mkontaridis@mmri.edu)). Author contributions Conceptualization: MIK Investigation: SLS Supervision: MIK Writing – original draft: SLS Writing – review & editing: SLS, MIK This paper is part of a Special Issue entitled Women’s Heart Health. Author Manuscript Author Manuscript Author Manuscript Author Manuscript Sommer and Kontaridis Page 2 Keywords cardio-rheumatology; women’s health; cardiovascular disease; rheumatic diseases; lupus; autoimmunity Introduction Cardiovascular diseases (CVDs), which include coronary heart disease, stroke, high blood pressure, heart failure, and diseases of the arteries, are responsible for approximately 1 million deaths per year in the US alone (Tsao et al. 2023) . Despite the tremendous efforts within the field over the last several decades, including the development and use of blood-pressure lowering medications, statins, and the invention of life-saving devices such as the pacemaker and defibrillator (Willy et al. 2022), the incidence and mortality of CVD is and remains the number one cause of death worldwide. Moreover, and perhaps more concerningly, any improvements and successes in CVD diagnosis and treatment have not been shared equally amongst the sexes; until recently, most CVD research had only been conducted in men or in male mice. Even the most recent CVD clinical trials are still comprised of~65% men (Tobb et al. 2022), and further, women

FAQs

Why are women with rheumatic diseases considered especially vulnerable to cardiovascular disease?

Women have increased CVD mortality risk, and women account for about 80% of rheumatic diseases. The paper links this heightened vulnerability to RD-associated chronic inflammation and other contributing mechanisms.

What factors may mediate the increased CVD risk in women with rheumatic diseases?

The discussion suggests mediation through RD pathology itself and pharmacological induction of CVD, as well as other mechanisms that remain unidentified.

What does the paper aim to provide for patients and clinicians?

It reviews CVD risks in RD patients, highlights sex disparities in RD and CVD care, and summarizes current therapeutic and interventional options to help improve CVD care for women.

Sep 30, 2026

Uploaded by acoobca