A large factor is sex differences, from physiological to genomic. For example, women have fewer cholesterol crystals and calcium deposits in their artery plaque than men, which contributes to the way cardiovascular disease presents. Women are also more likely to have cardiovascular issues presenting as multiple narrowed vessels, while men are more likely to have “clogged” arteries in a concentrated area that can be more easily treated via stent or bypass surgery. The X-chromosome plays an additional role, where several genes escaping the inactivation of one of the chromosomes in women are responsible for regulating processes like aortic valve stenosis, restricting blood flow to the heart.