Key result
Among individuals with spinal cord injury, male sex was associated with a higher prevalence of heart disease compared to female sex (22.9% vs 8.7%; OR 3.44, 95% CI 1.70-6.95).
Why the study?
Cardiovascular disease risk is amplified after spinal cord injury, but whether this risk differs between sexes remains unknown.
Does male sex increase the prevalence of self-reported heart disease more in individuals with spinal cord injury compared to able-bodied individuals?
Cross-Sectional (n=60,959)
Does male sex increase the prevalence of self-reported heart disease more in individuals with spinal cord injury compared to able-bodied individuals?
Odds Ratio: 3.44 (95% CI 1.7–6.95)
Absolute Event Rate: 22.9% vs 8.7%
Spinal cord injury amplifies sex-related differences in heart disease prevalence, with males at significantly higher risk than females.
Spinal cord injury may amplify male heart disease risk; leaves open whether this interaction warrants targeted screening pending prospective data.
CONTEXT/OBJECTIVE: The risk for cardiovascular disease is amplified following spinal cord injury, but whether risk differs between the sexes remains unknown. Here, we evaluated sex differences in the prevalence of heart disease among individuals with spinal cord injury, and compared sex differences with able-bodied individuals. DESIGN: The design was a cross-sectional study. Multivariable logistic regression analysis was conducted, using inverse probability weighting to account for the sampling method and to adjust for confounders. SETTING: Canada. PARTICIPANTS: Individuals who participated in the national Canadian Community Health Survey. INTERVENTIONS: Not applicable. OUTCOME MEASURES: Self-reported heart disease. RESULTS: Among 354 individuals with spinal cord injury, the weighted prevalence of self-reported heart disease was 22.9% in males and 8.7% in females, with an inverse-probability weighted odds ratio of 3.44 (95% CI 1.70-6.95) for males versus females. Among 60,605 able-bodied individuals, the prevalence of self-reported heart disease was 5.8% in males and 4.0% in females, with an inverse probability weighted odds ratio of 1.62 (95% CI 1.50-1.75) for males versus females. The effect of male sex on increasing heart disease prevalence was about two times higher among individuals with spinal cord injury than able-bodied individuals (relative difference in inverse probability weighted odds ratios = 2.12, 95% CI 1.08-4.51). CONCLUSION: Males with spinal cord injury exhibit a significantly higher prevalence of heart disease, compared with females with spinal cord injury. Moreover, relative to able-bodied individuals, spinal cord injury amplifies sex-related differences in heart disease. Overall, this work will inform targeted cardiovascular prevention strategies, and may also inform a better understanding of cardiovascular disease progression in both able-bodied and individuals with spinal cord injury.
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Jia et al. (2023) conducted a cross-sectional in Spinal cord injury (n=60,959). Male sex vs. Female sex was evaluated on Self-reported heart disease (OR 3.44, 95% CI 1.70-6.95). Among individuals with spinal cord injury, male sex was associated with a higher prevalence of heart disease compared to female sex (22.9% vs 8.7%; OR 3.44, 95% CI 1.70-6.95).
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