REVIEWSSex differences in pressure and flow waveform physiology across the life coursePicone, Dean S.a; Kodithuwakku, Vimarshaa; Mayer, Christopher C.b; Chapman, Niamha; Rehman, Sabaha; Climie, Rachel E.a Author Information aMenzies Institute for Medical Research, University of Tasmania, Hobart, Australia bMedical Signal Analysis, Center for Health & Bioresources, AIT Austrian Institute of Technology, Vienna, Austria Correspondence to Dr Rachel E. Climie, PhD, Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart 7001, Australia. E-mail: [email protected] Abbreviations: BP, blood pressure; CVD, cardiovascular disease; NO, nitric oxide; PWV, pulse wave velocity; SEVR, sub-endocardial viability ratio Received 30 July, 2022 Accepted 31 July, 2022 Journal of Hypertension 40(12):p 2373-2384, December 2022. | DOI: 10.1097/HJH.0000000000003283 Buy Metrics Abstract Cardiovascular disease (CVD) has long been deemed a disease of old men. However, in 2019 CVD accounted for 35% of all deaths in women and, therefore, remains the leading cause of death in both men and women. There is increasing evidence to show that risk factors, pathophysiology and health outcomes related to CVD differ in women compared with men, yet CVD in women remains understudied, underdiagnosed and undertreated. Differences exist between the sexes in relation to the structure of the heart and vasculature, which translate into differences in blood pressure and flow waveform physiology. These physiological differences between women and men may represent an important explanatory factor contributing to the sex disparity in CVD presentation and outcomes but remain understudied. In this review we aim to describe sex differences in arterial pressure and flow waveform physiology and explore how they may contribute to differences in CVD in women compared to men. Given that unfavourable alterations in the cardiovascular structure and function can start as early as in utero, we report sex differences in waveform physiology across the entire life course. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.