title: Sex-based differences in premature first myocardial infarction caused by smoking: twice as many years lost by women as by men.
abstract: BACKGROUND
  It has been debated whether smoking increases the risk of heart disease relatively more in women than in men. It is not known whether there are sex differences with regard to how many years prematurely smoking causes acute myocardial infarction (AMI) to occur. We aimed to determine how smoking affects the age of onset of first myocardial infarction in both the sexes.
  
  
  METHODS
  Clinical data were consecutively entered into a database and were analysed with a multivariate regression technique.
  
  
  METHODS
  In the years 1998-2005, data on 1784 consecutive patients (38.3% women) who were discharged from or died in a district general hospital with a diagnosis of first myocardial infarction were included in the study. Age at first AMI was analysed.
  
  
  RESULTS
  Unadjusted mean ages were 76.2 years for women and 69.8 years for men, a difference of 6.4 years (P<0.001). Mean age within the various groups was: women nonsmokers 80.7 years, women smokers 66.2 years, difference 14.4 years (P<0.001); men nonsmokers 72.2 years, men smokers 63.9 years, difference 8.3 years (P<0.001). After adjustment for risk factors (hypertension, cholesterol levels, diabetes) and patient characteristics (history of angina, history of stroke) 13.7 years of the age difference in women were attributed to smoking; the corresponding figure in men was 6.2 years (P<0.001).
  
  
  CONCLUSIONS
  First AMI occurred significantly more prematurely in women than in men smokers, implying that twice as many years were lost by women as by men smokers.
authors.affiliation: Department of Medicine, Innlandet Hospital Trust, Division Lillehammer, Lillehammer, Norway. mgrundtv@online.no
authors.forename: Morten
authors.initials: M
authors.lastname: Grundtvig
authors.forename: Terje P
authors.initials: TP
authors.lastname: Hagen
authors.forename: Mikael
authors.initials: M
authors.lastname: German
authors.forename: Asmund
authors.initials: A
authors.lastname: Reikvam
mesh_terms: D017677:Age Distribution; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D019992:Databases as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology* / Q000401:mortality; D009664:Norway / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects* / Q000401:mortality; D016387:Women's Health