Vaccarino V et al. - Women largely share similar cardiovascular risk factors for ischaemic heart disease (IHD) with men; however, women with suspected or confirmed IHD have less coronary atherosclerosis than men, even though they are older and have more cardiovascular risk factors than men.

• Coronary endothelial dysfunction and microvascular disease have been proposed as important determinants in the aetiology and prognosis of IHD in women, but research is limited on whether sex differences in these mechanisms truly exist.
• Differences in the epidemiology of IHD between women and men remain largely unexplained, as it still remains a question as to why women are protected towards IHD until older age compared with men.
• A better understanding of the processes and mechanisms may improve the prevention and the clinical management of IHD in women.