Review articleAre women really more affected by vasovagal syncope than men?Alboni, Paoloa; Messop, Anny Caroleb; Lauri, Alessandroc; Furlan, RaffaellodAuthor Information aSection of Cardiology bInternal Medicine cSection of Economics and Statistics, Ospedale Privato Quisisana, Ferrara dInternal Medicine, Humanitas Clinical and Research Center, IRCCS, Humanitas University, Rozzano, Italy Correspondence to Paolo Alboni, Section of Cardiology, Ospedale Privato Quisisana, Viale Cavour 128, 44121 Ferrara, Italy Tel: +39 532 207622; fax: +39 532 202646; e-mail: [email protected] Received 24 January, 2020 Revised 9 March, 2020 Accepted 1 May, 2020 Journal of Cardiovascular Medicine: February 2021 - Volume 22 - Issue 2 - p 69-78 doi: 10.2459/JCM.0000000000001009 Buy Metrics Abstract It is commonly reported that vasovagal syncope (VVS) is more frequent in women. Presently, this issue has never been investigated. The purpose of this review was to evaluate, through an extensive review of the literature, whether women are really more affected by VVS than men. The gender distribution was investigated in individuals with classical and nonclassical VVS. The database PubMed was searched using the terms ‘syncope’, ‘vasovagal syncope’, ‘neurally mediated syncope’ and ‘tilt testing’. Twelve studies dealing with classical and 75 with nonclassical VVS were eligible. In the individuals with classical (N = 1861) and nonclassical VVS (N = 9696), a trend towards a greater percentage of women emerged (P = 0.14 and 0.07, respectively). In the total population with VVS (N = 11 557), the percentage of women was significantly higher than that of men (58 versus 42%, P = 0.03). Most of the individuals were young or middle-aged. In 84% of the studies, the percentage of women was greater than that of men. A separate analysis was carried out in older VVS patients (≥60 years) and only two studies were eligible to be evaluated. Considering that almost all the studies were carried out in the western nations, where the number of men and women is almost superimposable until the age of 65 years and a bias by gender has never been reported in the management of VVS, these data strongly suggest that young and middle-aged women are more affected by VVS than their male counterparts. At present, data are too scant to draw a definitive conclusion in older VVS patients. © 2020 Italian Federation of Cardiology - I.F.C. All rights reserved.