Sex disparities in cardiovascular risk among older adults: insights from the Tehran cohort study (TeCS)
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Key result
Older men face ~13% higher 10-year cardiovascular risk than women despite fewer modifiable cardiometabolic factors.
- P<0.001
- n=1,791
Population
1,791 adults aged ≥ 65 years enrolled in the recruitment phase of the Tehran Cohort Study in Iran.
Design
Cross-sectional
Authors
Discussion
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Implication
Sex disparities in CAD prevalence and risk factors among older Iranians warrant sex-stratified assessment; leaves open whether targeted prevention alters outcomes.
Key Points
- To examine sex-specific differences in major cardiovascular disease risk factors and predicted 10-year cardiovascular risk among community-dwelling older adults.
- Analyzed cross-sectional baseline data from 1,791 older adults aged ≥ 65 years (mean age 72.4 ± 6.5 years, 52.5% male) enrolled in the Tehran Cohort Study in Iran.
- Calculated 10-year risk of cardiovascular events in 1,154 eligible participants using SCORE2 for individuals aged 65–69 without diabetes and SCORE2-OP for individuals aged ≥ 70.
- Men had a higher prevalence of established coronary artery disease (26.6% vs. 14.0%, P < 0.001) and a higher frequency of predicted 10-year high-risk status > 15% (62.8% vs. 53.9%, P < 0.001).
- Women had significantly higher rates of hypertension (62.7% vs. 51.2%, P < 0.001), diabetes (34.1% vs. 30.5%, P < 0.001), dyslipidemia (57.3% vs. 41.5%, P < 0.001), obesity (42.9% vs. 20.1%, P < 0.001), and metabolic syndrome (54.0% vs. 31.3%, P < 0.001).
- Median predicted 10-year cardiovascular risk was 17.22% [11.35, 26.87] overall (18.23% in men vs. 16.09% in women), and higher educational attainment was significantly associated with lower risk (P < 0.001).
Study Design
Type
Cross-Sectional (n=1,791)
Structured PICO
P
Population
1,791 community-dwelling adults aged 65 years and older in Tehran, Iran, assessed for cardiovascular risk factors and predicted 10-year cardiovascular risk.
O
Outcome
Sex differences in major cardiovascular disease risk factors and predicted 10-year cardiovascular risk using SCORE2 and SCORE2-OP.
Main Result
Absolute Event Rate: 18.23% vs 16.09%
p-value: p=<0.001
In older adults in Tehran, men have a higher prevalence of established CAD and higher predicted 10-year cardiovascular risk, while women have a higher burden of modifiable cardiometabolic risk factors.
Limitations
- Cross-sectional design without long-term real-world cardiovascular event assessment
- SCORE2 and SCORE2-OP risk models have not been validated in the Iranian population
- Exclusion of individuals with CAD and diabetic participants aged 65-69 years from risk calculation may underestimate true risk
- Absence of detailed medication data, particularly statin and antihypertensive use
- Small sample sizes in some postal regions limited spatial analysis of high-risk individuals
- Exclusion of diabetic individuals aged 65-69 from risk calculation due to lack of HbA1c data
Cite This Study
Javid et al. (2026) conducted a cross-sectional in Cardiovascular risk (n=1,791). Male sex vs. Female sex was evaluated on Median predicted 10-year cardiovascular risk (p=<0.001). Older men in Tehran had a higher median predicted 10-year cardiovascular risk (18.23% vs 16.09%) and higher rates of established coronary artery disease compared to women, despite women bearing a heavier burden of modifiable cardiometabolic risk factors.
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