Although the underlying mechanisms for this disparity are not fully understood, they could be related to differences in smoking and drinking patterns between sexes, the effect of smoking on lowering oestrogen levels (oestrogen has protective effects against atherosclerosis in female), genetic differences related to thrombin signalling, or metabolic differences (females generally have a lower body water content and lower alcohol dehydrogenase activity compared to males, which may contribute to higher CVD risk in females).26, 28, 29, 30. The gene discussed is AKR1A1; the disease is atherosclerosis.