Why the study?
Sex differences in cardiometabolic risk factors had not been fully explored across age or age-related factors such as menopause.
Cohort (n=501,389)
Yes
Effect estimate: -12.5% difference (95% CI -12.8 to -12.2)
Absolute Event Rate: 14.9% vs 27.4%
While overall cardiometabolic risk factor burden is lower in women, clinically important disparities exist with women having poorer treatment and control of dyslipidemia, and worse lipid profiles emerging at older ages and post-menopause.
BACKGROUND: Sex differences have not been fully explored for certain risk factors or by age or age-related factors, such as menopause. We addressed this issue in a large population cohort. METHODS: UK Biobank participants with ≥1 risk factor measured at baseline were included. We assessed sex differences, by age and menopausal status, in prevalence, treatment and control of cardiometabolic risk factors. RESULTS: ), waist circumference (-12.2 cm), triglycerides (0.34 mmol/L), glycated haemoglobin (-0.52 mmol/mol) and glucose (-0.08 mmol/L), while high-density lipoprotein cholesterol (+0.31 mmol/L) and C reactive protein (+0.08 mg/L) were higher among women. Total cholesterol and low-density lipoprotein cholesterol (LDL-C) were lower in women than men at younger ages (-0.23 and -0.30 mmol/L, respectively, at <50 years), and higher at older ages (+0.74 and +0.41 mmol/L, at ≥60 years). Total cholesterol and LDL-C were lower in premenopausal women (-0.29 and -0.34 mmol/L, respectively) and higher in postmenopausal women (+0.61 and +0.31 mmol/L), compared with similarly aged men. Prevalence was lower among women than men for current smoking (-3.6%), hypertension (-13.9%), obesity (-1.9%) and diabetes (-2.0%), and sex differences were smaller at older ages and in postmenopausal women. Dyslipidaemia prevalence was lower in women aged <50 years (-8.8%) and premenopausal women (-11.0%), and higher in women aged ≥60 years (+5.4%) and postmenopausal women (+4.6%). Treatment and control of dyslipidaemia were lower in women than men (-12.5% and -12.6%, respectively). CONCLUSIONS: Effective public health policy is required to address suboptimal risk factor prevalence, treatment and control in both sexes. Targeted interventions may be warranted to address dyslipidaemia among women at older ages.
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Kelly et al. (2025) conducted a cohort in Cardiometabolic risk factors (n=501,389). Female sex vs. Male sex was evaluated on Treatment of dyslipidaemia (-12.5% difference, 95% CI -12.8 to -12.2).
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