title: Sex disparities in risk and risk factors for ischemic heart disease in the Asia-Pacific region.
abstract: BACKGROUND
  Ischemic heart disease (IHD) is the leading cause of death and disability worldwide, with higher rates among men than women. Relatively few studies on risk factor associations are available from the Asia-Pacific region, especially with regard to sex differences. Our objective was to compare the relationships between modifiable risk factors and IHD in men and women from the Asia-Pacific region.
  
  
  METHODS
  Data from 600,445 individuals from 44 studies from the Asia Pacific Cohort Studies Collaboration, an individual patient data overview, were used. Cox models were used to evaluate the effects of risk factors on fatal and non-fatal IHD separately in men and women from Australia and New Zealand (ANZ) and Asia.
  
  
  RESULTS
  Over a median follow-up of 6.7 years, 5695 IHD events were documented. The hazard ratio for IHD, comparing men with women, was 2.14 (95% CI 1.97-2.33) in ANZ and 1.88 (95% CI 1.54-2.29) in Asia. The age-adjusted prevalence of major risk factors was generally higher in men than women, especially in ANZ. Risk factors acted broadly similarly between men and women in both Asia and ANZ, with any indications of differences tending to favor men, rather than women.
  
  
  CONCLUSIONS
  The excess risk of IHD observed in men compared with women in both Asia and ANZ may be, at least in part, a result of a more hazardous risk profile in men compared with women. The contribution of sex differences in the magnitude of the risk factor-disease associations is unlikely to be a contributing factor.
authors.affiliation: The George Institute for Global Health, University of Sydney, Australia.
authors.forename: Sanne Ae
authors.initials: SA
authors.lastname: Peters
authors.forename: Mark
authors.initials: M
authors.lastname: Woodward
authors.forename: Tai H
authors.initials: TH
authors.lastname: Lam
authors.forename: Xianghua
authors.initials: X
authors.lastname: Fang
authors.forename: Il
authors.initials: I
authors.lastname: Suh
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Ueshema
authors.forename: Annette J
authors.initials: AJ
authors.lastname: Dobson
authors.forename: Diederick E
authors.initials: DE
authors.lastname: Grobbee
authors.forename: Rachel R
authors.initials: RR
authors.lastname: Huxley
mesh_terms: D000328:Adult; D000368:Aged; D001208:Asia / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D009520:New Zealand / Q000453:epidemiology; D015995:Prevalence; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors
keywords: Asia-Pacific region; Ischemic heart disease; global health; risk factors; sex differences