title: Risk of acute myocardial infarction: dyslipidemia more detrimental for men than women.
abstract: BACKGROUND
  Endogenous estrogens prevent lipid peroxidation, which is pivotal in atherogenesis. Dyslipidemia may therefore be more dangerous for men than for women as a risk factor for acute myocardial infarction (AMI). A differential effect by sex has not been empirically established.
  
  
  METHODS
  In a prospective population-based cohort study of 23,525 women and 20,725 men younger than 60 years of age at baseline, we followed participants for 12 years for a first AMI. By calculating the proportion of AMI among men with dyslipidemia attributable to the synergism between male sex and dyslipidemia, we assessed the degree to which dyslipidemia is more detrimental for men than for women.
  
  
  RESULTS
  Dyslipidemia and male sex enhanced the effect of one another in relation to AMI risk. The proportion of AMI cases among men with dyslipidemia attributable to this synergism alone was 0.46 (95% confidence interval = 0.35 to 0.57) for high total serum cholesterol, 0.23 (0.05 to 0.41) for low high-density lipoprotein (HDL) cholesterol, and 0.52 (0.42 to 0.62) for high non-HDL cholesterol. In contrast, obesity and hypertension were equally detrimental for men and women in relation to AMI risk, with a corresponding attributable proportion of 0.02 (-0.21 to 0.25) and -0.01 (-0.27 to 0.24), respectively.
  
  
  CONCLUSIONS
  Current clinical guidelines of dyslipidemia management do not distinguish between men and women in relation to primary prevention of AMI. Our results suggest that in middle age, dyslipidemia is much more detrimental for men than for women, and that preventing dyslipidemia has a greater potential to reduce the occurrence of AMI among men.
authors.affiliation: Department of Circulation and Medical Imaging Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Erik
authors.initials: E
authors.lastname: Madssen
authors.forename: Lars Erik
authors.initials: LE
authors.lastname: Laugsand
authors.forename: Rune
authors.initials: R
authors.lastname: Wiseth
authors.forename: Bjørn
authors.initials: B
authors.lastname: Mørkedal
authors.forename: Carl
authors.initials: C
authors.lastname: Platou
authors.forename: Lars
authors.initials: L
authors.lastname: Vatten
authors.forename: Imre
authors.initials: I
authors.lastname: Janszky
mesh_terms: D000328:Adult; D050171:Dyslipidemias / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution