Fundamentally, it is not surprising that men and women can differ.
At the very least, cells from males contain a Y chromosome, express the Sry gene, and males produce testosterone (T) in the testes ().
The premise of this review is that while both sexes possess the same structural elements and are in fluid balance, how those elements function to achieve homeostasis with respect to the CV system differs (from subtly to profoundly).
Manifestations of these differences have real consequences relative to how and when fluid and solute exchange are disrupted, how these dysfunctions can be prevented, and the strategies for ameliorating or treating these manifestations effectively.
In males and females, the same formed elements circulate in blood, the vessels are composed of the same cell types, and the union of the elements performs the same functions. Consequently, the conclusion that the functions and responses of these common elements do not differ with sex is not outlandish.
In fact, notable features exist that influence basal function in men and women differently, those that induce sex-linked responses, those that are indistinguishable between the sexes, and yet others that, while appearing to differ, are without known functional consequence.
This review focuses on sex differences of parameters influencing exchange at the point of union between blood and tissue, the microvasculature.
Microvascular architecture, blood pressure (hydrostatic and oncotic), and vascular permeability, therefore, are discussed in the specific context of sex in health and disorders.
Thus, in volume balance, from all perfused vessels is equal to lymph flow and interstitial fluid volume is constant.
Exchange involves solute and fluid movement as Δπ is driven by the distribution of hydrophilic molecules across the barrier.
The extent to which they differ by sex in health and/or disease is not well defined.
While text books refer to ‘normal’ arterial blood pressure (BP) as 120/80 mm Hg, the BP of healthy adult human females is lower than males.
It is essential to realize that every cell of the body has ‘sex’ due to the presence of either XX or XY chromosomes, that sex is manifest in the womb, and that beyond behaviour, biological differences exist in the CV system before puberty.