title: Risk of Incident Coronary Heart Disease Events in Men Compared to Women by Menopause Type and Race.
abstract: BACKGROUND
  We examined whether type of menopause affects sex differences in coronary heart disease (CHD) events and whether the impact is similar in blacks and whites.
  
  
  RESULTS
  Participants were enrolled in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort between 2003 and 2007 without CHD at baseline (n=23 086). Cox regression models were used to calculate the hazard of incident nonfatal CHD (definite or probable myocardial infarction) and acute CHD death, adjusting for age, age at last menstrual period <45 years, region, education level, income, diabetes, smoking, systolic blood pressure, lipid levels, albumin-creatinine ratio, physical activity, C-reactive protein, body mass index, waist circumference, and medication use. White women in natural menopause (hazard ratio [HR], 0.45; 95% confidence interval [CI], 0.31, 0.66) and surgical menopause (HR, 0.65; 95% CI, 0.42, 0.99) had a reduced hazard of nonfatal events, compared to white men. Black women in natural menopause (HR, 0.69; 95% CI, 0.47, 1.03), but not surgical menopause (HR, 0.81; 95% CI, 0.51, 1.29), had a marginally reduced hazard of nonfatal events, compared to black men. Women had lower risk of acute CHD death than men regardless of their menopause type and race.
  
  
  CONCLUSIONS
  Sex differences in the risk of incident CHD events were larger among whites than blacks and varied by type of menopause. Women consistently had a lower risk of incident CHD death than men, but the magnitude of sex differences was greater in whites than blacks for nonfatal events, regardless of menopause type.
authors.affiliation: Departments of Medicine and Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI (C.K.).
authors.forename: Catherine
authors.initials: C
authors.lastname: Kim
authors.affiliation: Department of Medicine, University of Vermont, Burlington, VT (M.C.).
authors.forename: Mary
authors.initials: M
authors.lastname: Cushman
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham, AL (Y.K., M.M.S.).
authors.forename: Yulia
authors.initials: Y
authors.lastname: Khodneva
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (L.D.L.).
authors.forename: Lynda D
authors.initials: LD
authors.lastname: Lisabeth
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, AL (S.J., V.J.H.).
authors.forename: Suzanne
authors.initials: S
authors.lastname: Judd
authors.affiliation: University of Cincinnati, OH (D.O.K.).
authors.forename: Dawn O
authors.initials: DO
authors.lastname: Kleindorfer
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, AL (S.J., V.J.H.).
authors.forename: Virginia J
authors.initials: VJ
authors.lastname: Howard
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham, AL (Y.K., M.M.S.).
authors.forename: Monika M
authors.initials: MM
authors.lastname: Safford
mesh_terms: D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D003327:Coronary Disease / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007044:Hysterectomy; D015994:Incidence; D008297:Male; D008593:Menopause / Q000208:ethnology*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality; D010052:Ovariectomy; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D044465:White People
keywords: coronary disease; epidemiology; sex; women