Isaac T Cheng, Huan Meng, Ho So, Lai Shan Tam
Spondyloarthritis encompasses a spectrum of inflammatory diseases, including axial spondyloarthritis and peripheral forms such as psoriatic arthritis. Chronic inflammation is closely linked to an increased risk of cardiovascular (CV) disease in these patients. Beyond inflammatory burden, biological sex and sex hormones may modify both inflammatory pathways and CV risk. Although the mechanisms underlying sex differences in spondyloarthritis remain incompletely understood, emerging evidence suggests clinically relevant differences in disease manifestations, inflammatory activity, and CV outcomes between males and females. This review summarizes current evidence on the interplay between sex, sex hormones, inflammatory burden, and CV risk in patients with spondyloarthritis, and highlights potential implications for risk stratification and future research.