Key result
Male sex is linked to a ~49% higher lifetime risk of incident CVD compared to women.
Why the study?
A better understanding of sex differences in CVD is essential to tailor appropriate preventative strategies.
Does male sex increase the lifetime risk of incident CVD and CV mortality compared to female sex in a general population cohort?
Cohort (n=23,859)
Does male sex increase the lifetime risk of incident CVD and CV mortality compared to female sex in a general population cohort?
Effect estimate: cHR 1.49 (95% CI 1.41-1.57)
Absolute Event Rate: 69.1% vs 57.7%
Men have a substantially higher lifetime risk of incident CVD and CV mortality than women, highlighting the need for sex-specific cardiovascular prevention strategies.
Men face higher lifetime CVD risk than women; leaves open whether sex-specific strategies warrant trials.
AIMS: Better understanding of sex differences in cardiovascular disease (CVD) is essential in tailoring appropriate preventative strategies. Using a large population-based study with follow-up >25 years, we aimed to determine sex-specific lifetime risks of incident CVD and cardiovascular (CV) mortality amongst populations with and without prevalent CVD. METHODS AND RESULTS: Participants were drawn from the European Prospective Investigation into Cancer-Norfolk and followed up for a median of 26.2 years. Sex-specific lifetime risks were ascertained accounting for the competing risk of death. Models were adjusted for ethnicity and time-updated covariates: material deprivation, CV risk factors, lifestyle factors, comorbidities, and medication. A total of 23 859 participants [54.5% women; mean age (standard deviation) 59.2 (9.3) years at baseline] were included. Adjusted lifetime risks of incident CVD were higher in men than in women (69.1 vs. 57.7% at age 75): cause-specific hazard ratio (cHR) (99% confidence interval)-1.49 (1.41-1.57), while the risks of CV mortality at age 75 were 4.4% (men) and 3.1% (women): cHR-1.42 (1.31-1.54). Myocardial infarction was the predominant first presentation in men until the eighth decade. In women, the first CVD manifestations after their sixth decade were predominantly atrial fibrillation and stroke. The male-associated excess relative risks of incident CVD and CV mortality were halved in people with prevalent CVD. CONCLUSION: We characterized the sex-specific lifetime CV risks in a large cohort. Men had substantially higher risk of incident CVD and CV mortality than women, which was attenuated amongst people with prevalent CVD. Our findings provide an evidence base for sex-specific CV prevention.
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Pana et al. (2023) conducted a cohort in Cardiovascular disease (n=23,859). Male sex vs. Female sex was evaluated on Incident CVD at age 75 (cHR 1.49, 95% CI 1.41-1.57). Men had a substantially higher adjusted lifetime risk of incident cardiovascular disease compared to women (69.1% vs. 57.7% at age 75; cHR 1.49, 99% CI 1.41-1.57).
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