RT Journal Article SR Electronic T1 Sex and gender in pulmonary arterial hypertension JF European Respiratory Review JO EUROPEAN RESPIRATORY REVIEW FD European Respiratory Society SP 200330 DO 10.1183/16000617.0330-2020 VO 30 IS 162 A1 Céline Cheron A1 Susan Ainslie McBride A1 Fabrice Antigny A1 Barbara Girerd A1 Margot Chouchana A1 Marie-Camille Chaumais A1 Xavier Jaïs A1 Laurent Bertoletti A1 Olivier Sitbon A1 Jason Weatherald A1 Marc Humbert A1 David Montani YR 2021 UL http://err.ersjournals.com/content/30/162/200330.abstract AB Pulmonary arterial hypertension (PAH) is a rare disease characterised by pulmonary vascular remodelling and elevated pulmonary pressure, which eventually leads to right heart failure and death. Registries worldwide have noted a female predominance of the disease, spurring particular interest in hormonal involvement in the disease pathobiology. Several experimental models have shown both protective and deleterious effects of oestrogens, suggesting that complex mechanisms participate in PAH pathogenesis. In fact, oestrogen metabolites as well as receptors and enzymes implicated in oestrogen signalling pathways and associated conditions such as BMPR2 mutation contribute to PAH penetrance more specifically in women. Conversely, females have better right ventricular function, translating to a better prognosis. Along with right ventricular adaptation, women tend to respond to PAH treatment differently from men. As some young women suffer from PAH, contraception is of particular importance, considering that pregnancy in patients with PAH is strongly discouraged due to high risk of death. When contraception measures fail, pregnant women need a multidisciplinary team-based approach. This article aims to review epidemiology, mechanisms underlying the higher female predominance, but better prognosis and the intricacies in management of women affected by PAH.Pulmonary arterial hypertension affects women more than men, although women have a better prognosis. Oestrogens might be the key to explain these gender differences. https://bit.ly/36KK1yX