title: Does the clinical spectrum of incident cardiovascular disease differ between men and women?
abstract: BACKGROUND
  Cardiovascular diseases (CVDs) are the main cause of death and disability in the western world. Women are known to be older at the time of first CVD event, but the main types of CVD events and their relative importance and differences compared with men are not well known. Our aim was to evaluate gender differences in the clinical presentation of incident major adverse cardiovascular events (MACE).
  
  
  METHODS
  A population-based study with prospective follow-up.
  
  
  METHODS
  We used data from the population-based National FINRISK Surveys from years 1992, 1997, 2002 and 2007. People with prevalent cardiovascular disease were excluded. In total, 27,897 participants (53, 2% women) aged 25-74 years were included in the analyses.
  
  
  RESULTS
  During the 292,316 person-years of follow-up, 2573 MACE were identified. MACE were more frequent in men than women (1318; 95% CI 1252-1388 in men vs. 736; 686-789 in women). Men had four times more fatal coronary heart disease (CHD) events (149; 126-174 vs. 39; 28-53) and three times more non-fatal CHD events (512; 471-555 vs. 164; 141-189) than women. Stroke incidence was higher in men than women (268; 238-301 vs. 169; 145-195). Heart failure (HF) incidence did not differ between genders. The relative proportions of MACE categories differed substantially between genders: HF was the most common type among women (50% vs. 30% in men), whereas the most common type among men was CHD (50% vs. 28% in women).
  
  
  CONCLUSIONS
  Incident MACE were more common in men than women. HF was the dominant type of MACE in women, whereas CHD dominated in men.
authors.affiliation: University of Kuopio, Department of Medicine, Finland hrleht@utu.fi.
authors.forename: Hanna-Riikka
authors.initials: HR
authors.lastname: Lehto
authors.affiliation: University of Kuopio, Department of Medicine, Finland.
authors.forename: Seppo
authors.initials: S
authors.lastname: Lehto
authors.affiliation: National Institute for Health and Welfare (THL), Finland.
authors.forename: Aki S
authors.initials: AS
authors.lastname: Havulinna
authors.affiliation: National Institute for Health and Welfare (THL), Finland.
authors.forename: Veikko
authors.initials: V
authors.lastname: Salomaa
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors
keywords: Major adverse cardiovascular event; cardiovascular disease; gender difference; incidence