Risk factors that attenuate the female coronary disease advantage.
OBJECTIVE
To compare the coronary disease experience of men and women in a community setting.


METHODS
Prospective cohort study.


METHODS
Long-term follow-up of a population-based sample of 5209 men and women.


RESULTS
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.


CONCLUSIONS
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.
Kannel
W B
WB
Department of Medicine, Evans Memorial Research Foundation, Boston University School of Medicine, Mass.
Wilson
P W
PW
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology*; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D017379:Hypertrophy, Left Ventricular / Q000150:complications; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution