[Sex differences in cardiovascular drug targeting].

Women and men differ in drug needs and drug metabolism. Usually women are smaller and lighter and have a higher body fat percentage and lower kidney function. Primary drug-metabolizing enzymes in the intestinal wall and liver, which are part of the cytochrome P450 family, have different activities in men and women. Their substrates (beta-blockers, blockers of calcium channels such as nifedipine and verapamil, cyclosporine, and many others) are metabolized differently. Sex differences were observed after administration of digitalis, which is often overdosed in women. Furthermore, beta-blockers are found at higher plasma levels in women and ACE inhibitors cause more side effects in women than in men. In women, acetylsalicylic acid provides effective primary prophylaxis against stroke but not myocardial infarction. In men, these drugs have opposite effects. Anticoagulants and thrombolytics often lead to bleeding complications in women, QT prolonging drugs produce more frequently arrhythmia. It is therefore very important to control drugs following approval and to look out for these differences between men and women.