Risk Factors That Attenuate the Female Coronary Disease Advantage

TLDR

By middle age, women lag 20 years behind men in myocardial infarction incidence, but the gap closes in older age when cardiovascular disease becomes the leading cause of death for both sexes. The study aims to compare coronary disease experience between men and women in a community setting, emphasizing the need for vigorous preventive measures and focused attention on glucose tolerance, lipid levels, and hypertension‑related left ventricular hypertrophy in women. A prospective cohort study with long‑term follow‑up of 5,209 men and women was conducted to assess coronary disease outcomes. Menopause triples coronary disease risk and erodes the female advantage, while high total/HDL cholesterol ratios, left ventricular hypertrophy, and diabetes eliminate it, underscoring that women face significant coronary disease risk despite lower absolute rates.

Abstract

To compare the coronary disease experience of men and women in a community setting.Prospective cohort study.Long-term follow-up of a population-based sample of 5209 men and women.Women outlive men and experience fewer cardiovascular events. By middle age, women lag 20 years behind men in the incidence of myocardial infarction, but the gap closes in the elderly, when cardiovascular disease becomes the leading cause of death in women as well as in men. Menopause promptly escalates coronary disease risk threefold and greatly erodes the advantage over men. Women and men share the same major risk factors for coronary disease, although women experience a lower absolute risk. However, high ratios of total/high-density lipoprotein cholesterol level ratios, left ventricular hypertrophy, and diabetes tend to eliminate the female advantage.Coronary disease is not a minor problem in women. Consequently, women should take vigorous preventive measures. There is a need for particular attention to glucose tolerance and blood lipid levels and a greater sense of urgency when hypertension progresses to left ventricular hypertrophy.