Integrating sex and gender in model simulations of cardiovascular flows: a narrative review.

Gender medicine is providing increasingly abundant evidence of the pivotal role played by sex and gender in the pathophysiology of the human circulatory system. Therefore, any medical or nonmedical scientific activity focused on cardiovascular issues must integrate sex and/or gender among the variables that drive blood circulation in order to guarantee the accuracy of the methodological approach, improve the understanding of cardiovascular biomechanical processes, promote a truly personalised medicine, and, last but not least, foster gender equality in healthcare. A preliminary review of the most recent literature in the field of cardiovascular flows simulation models is given here, aimed at highlighting if engineering replicas of blood circulation are usually developed according to a gender perspective, i.e., if they pay appropriate attention to sex differences and/or gender factors along the entire process of modelling. The proposed examples show that there seems to be a lack of awareness of the basic concepts and alerts spread by gender medicine in the community of cardiovascular flows modellers. Possible reasons and mitigation strategies for such a situation are discussed in the conclusions.