Are coronary event rates declining slower in women than in men - evidence from two population-based myocardial infarction registers in Finland?
BACKGROUND
Studies have suggested that the prevention and treatment of coronary heart disease may not have been as effective in women as in men. Therefore, we aimed to examine whether the incidence, attack rate and mortality of myocardial infarction (MI) events have declined less in women than in men.


METHODS
Two large population-based MI registers, the FINAMI register and the Finnish Cardiovascular Disease Register (CVDR) were used for comparing the event rates among men and women aged > or =35 years in two time periods, 1994-1996 and 2000-2002.


RESULTS
In the FINAMI register a total of 5,252 events were recorded in men and 4,898 in women. Corresponding numbers in the CVDR were 78,709 and 70,464. Both FINAMI and CVDR data suggested smaller declines in incidence and attack rate of MI events in women than in men. In CVDR data the decline in mortality was also smaller in women than in men, while in FINAMI data this difference did not reach statistical significance. In the large CVDR data set, negative binomial regression models revealed smaller declines in incidence (p = 0.006), attack rate (p = 0.008) and mortality (p = 0.04) in women than in men aged <55 years. In persons > or =55 years no difference was observed between women and men.


CONCLUSIONS
The incidence and attack rate of MI events have declined less in women aged <55 than in men of similar age. In older persons no significant differences were observed. Further studies are warranted to find out the reasons why the development has been less favourable for young women than for men.
Lehto
Hanna-Riikka
HR
Turku University Hospital, Turku, Finland. hrleht@utu.fi
Lehto
Seppo
S
Havulinna
Aki S
AS
Ketonen
Matti
M
Lehtonen
Aapo
A
Kesäniemi
Y Antero
YA
Airaksinen
Juhani
J
Salomaa
Veikko
V
D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality; D011159:Population Surveillance; D012042:Registries / Q000706:statistics & numerical data; D012107:Research Design; D017678:Sex Distribution; D012737:Sex Factors; D013997:Time Factors