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How Does Cardiovascular Disease First Present in Women and Men? Incidence of 12 Cardiovascular Diseases in a Contemporary Cohort of 1,937,360 People.

George J, Rapsomaniki E, Pujades-Rodriguez M, Shah AD, Denaxas S, Herrett E, Smeeth L, Timmis A, Hemingway H - Circulation (2015)

Bottom Line: We compared the incidence of 12 cardiac, cerebrovascular, and peripheral vascular diseases in women and men at different ages.The majority of initial presentations of CVD are neither myocardial infarction nor ischemic stroke, yet most primary prevention studies focus on these presentations.Sex has differing associations with different CVDs, with implications for risk prediction and management strategies.

View Article: PubMed Central - PubMed

Affiliation: From Farr Institute of Health Informatics Research (London), University College London, United Kingdom (J.G., M.P.-R., A.D.S., S.D., H.H.); Worldwide Clinical Trials, Nottingham, United Kingdom (E.R.); Farr Institute of Health Informatics Research (London), London School of Hygiene & Tropical Medicine, United Kingdom (E.H., L.S.); and Farr Institute of Health Informatics Research (London) and Barts National Institute for Health Research Cardiovascular Biomedical Research Unit, Queen Mary University of London, United Kingdom (A.T.). j.george@ucl.ac.uk.

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Hazard ratios of men in comparison with women for initial presentation of 12 different cardiovascular diseases among a population of 1.93 million adults. CHD indicates coronary heart disease; CI, confidence interval; CVD, cardiovascular disease; HR, hazard ratio; NOS, not otherwise specified; and SCD, sudden cardiac death.
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Figure 2: Hazard ratios of men in comparison with women for initial presentation of 12 different cardiovascular diseases among a population of 1.93 million adults. CHD indicates coronary heart disease; CI, confidence interval; CVD, cardiovascular disease; HR, hazard ratio; NOS, not otherwise specified; and SCD, sudden cardiac death.

Mentions: SAH was less common in men (HR men versus women, 0.69; 95% confidence interval [CI], 0.59–0.79); other CVDs were positively associated with male sex but with considerable heterogeneity (τ2=0.196; Figure 2). Specifically, the age-adjusted HR (all P<0.001) was <1.5 for transient ischemic attack, intracerebral hemorrhage, and unstable angina, 1.5 to 2.0 for stable angina, ischemic stroke, PAD, heart failure, and cardiac arrest/SCD, and 3.6 to 5.0 for AAA, MI, and UCD. The age-adjusted HR for men versus women was 4.14 (95% CI, 3.72–4.60) in ST-segment–elevation MI and 3.18 (95% CI, 2.86–3.52) in non–ST-segment–elevation MI. These associations changed little after adjustment for conventional CVD risk factors and baseline medications, with the exception of intracerebral hemorrhage, where the association reduced to (Figure III in the online-only Data Supplement).


How Does Cardiovascular Disease First Present in Women and Men? Incidence of 12 Cardiovascular Diseases in a Contemporary Cohort of 1,937,360 People.

George J, Rapsomaniki E, Pujades-Rodriguez M, Shah AD, Denaxas S, Herrett E, Smeeth L, Timmis A, Hemingway H - Circulation (2015)

Hazard ratios of men in comparison with women for initial presentation of 12 different cardiovascular diseases among a population of 1.93 million adults. CHD indicates coronary heart disease; CI, confidence interval; CVD, cardiovascular disease; HR, hazard ratio; NOS, not otherwise specified; and SCD, sudden cardiac death.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4590518&req=5

Figure 2: Hazard ratios of men in comparison with women for initial presentation of 12 different cardiovascular diseases among a population of 1.93 million adults. CHD indicates coronary heart disease; CI, confidence interval; CVD, cardiovascular disease; HR, hazard ratio; NOS, not otherwise specified; and SCD, sudden cardiac death.
Mentions: SAH was less common in men (HR men versus women, 0.69; 95% confidence interval [CI], 0.59–0.79); other CVDs were positively associated with male sex but with considerable heterogeneity (τ2=0.196; Figure 2). Specifically, the age-adjusted HR (all P<0.001) was <1.5 for transient ischemic attack, intracerebral hemorrhage, and unstable angina, 1.5 to 2.0 for stable angina, ischemic stroke, PAD, heart failure, and cardiac arrest/SCD, and 3.6 to 5.0 for AAA, MI, and UCD. The age-adjusted HR for men versus women was 4.14 (95% CI, 3.72–4.60) in ST-segment–elevation MI and 3.18 (95% CI, 2.86–3.52) in non–ST-segment–elevation MI. These associations changed little after adjustment for conventional CVD risk factors and baseline medications, with the exception of intracerebral hemorrhage, where the association reduced to (Figure III in the online-only Data Supplement).

Bottom Line: We compared the incidence of 12 cardiac, cerebrovascular, and peripheral vascular diseases in women and men at different ages.The majority of initial presentations of CVD are neither myocardial infarction nor ischemic stroke, yet most primary prevention studies focus on these presentations.Sex has differing associations with different CVDs, with implications for risk prediction and management strategies.

View Article: PubMed Central - PubMed

Affiliation: From Farr Institute of Health Informatics Research (London), University College London, United Kingdom (J.G., M.P.-R., A.D.S., S.D., H.H.); Worldwide Clinical Trials, Nottingham, United Kingdom (E.R.); Farr Institute of Health Informatics Research (London), London School of Hygiene & Tropical Medicine, United Kingdom (E.H., L.S.); and Farr Institute of Health Informatics Research (London) and Barts National Institute for Health Research Cardiovascular Biomedical Research Unit, Queen Mary University of London, United Kingdom (A.T.). j.george@ucl.ac.uk.

Show MeSH
Related in: MedlinePlus