Article: Does sex matter in the associations between classic risk factors and fatal coronary heart disease in populations from the Asia-Pacific region?

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TitleDoes sex matter in the associations between classic risk factors and fatal coronary heart disease in populations from the Asia-Pacific region?
AuthorsHuxley, R1
Okayama, A
Ueshima, H
Maegawa, H
Aoki, N
Nakamura, M
Kubo, N
Yamada, T
Wu, ZS
Yao, CH
Andrews, G
Welborn, TA8
Tang, Z3
Liu, LS10
Xie, JX10
Norton, R
Ameratunga, S
Macmahon, S
Whitlock, G
Knuiman, MW
Christensen, H
Zhou, J6
Yu, XH6
Wu, XG7
Tamakoshi, A2
Pan, WH
Sritara, P
Wu, ZL
Chen, LQ
Shan, GL
Gu, DF
Duan, XF
Jackson, R
Li, YH
Lam, TH5
Jiang, CQ5
Fujishima, M
Kiyohara, Y
Iwamoto, H
Woo, J
Ho, SC
Hong, Z
Huang, MS
Zhou, B
Fuh, JL
Kita, Y
Choudhury, SR
Suh, I4
Jee, SH4
Kim, IS4
Giles, G9
Hashimoto, T
Sakata, K
Dobson, A
Imai, Y
Ohkubo, T
Hozawa, A
Jamrozik, K
Norman, P
Hobbs, M
Broadhurst, R
Nakachi, K
Fang, XH
Li, SC
Yang, QD
Chen, ZM
Tanaka, H
Nozaki, A
Horibe, H
Matsutani, Y
Kagaya, M
Hughes, K
Lee, J
Heng, D
Chew, SK
Zhou, BF
Zhang, HY
Shimamoto, K
Saito, S
Li, ZZ
Zhang, HY
He, Y
Lam, TH
Yao, SX
Issue Date2005
PublisherMary Ann Liebert, Inc Publishers. The Journal's web site is located at http://www.liebertpub.com/jwh
CitationJournal Of Women's Health, 2005, v. 14 n. 9, p. 820-827 [How to Cite?]
DOI: http://dx.doi.org/10.1089/jwh.2005.14.820
AbstractBackground: There is much interest in promoting healthy heart awareness among women. However, little is known about the reasons behind the lower rates of heart disease among women compared with men, and why this risk difference diminishes with age. Previous comparative studies have generally had insufficient numbers of women to quantify such differences reliably. Methods: We carried out an individual participant data meta-analysis of 39 cohort studies (32 from Asian countries and 7 from Australia and New Zealand). Cox models were used to estimate hazard ratios (HR) for coronary death, comparing men to women. Further adjustments were made for several proven coronary risk factors to quantify their contributions to the sex differential. Sex interactions were tested for the same risk factors. Results: During 4 million person-years of follow-up, there were 1989 (926 female) deaths from coronary heart disease (CHD). The age-adjusted and study-adjusted male/female HR (95% confidence interval [95% CI]) was 2.05 (1.89-2.22). At baseline, 54% of men vs. 7% of women were current smokers; hence, adjustment for smoking explained the largest component (20%) of this HR. A significant sex interaction was observed between systolic blood pressure (SBP) and CHD mortality such that a 10 mm Hg increase was associated with a 15% greater increase in the relative risk (RR) of coronary death in women compared with men (p = 0.002). Conclusions: Only a small amount of the sex differential in coronary death could be explained by differences in the prevalence of classic risk factors. Alternative explanations are required to explain the age-related attenuation of the sex difference in CHD risk. © Mary Ann Liebert, Inc.
ISSN1540-9996
2011 Impact Factor: 1.569
2011 SCImago Journal Rankings: 0.127
DOIhttp://dx.doi.org/10.1089/jwh.2005.14.820
ISI Accession Number IDWOS:000234347900005
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorHuxley, R
dc.contributor.authorOkayama, A
dc.contributor.authorUeshima, H
dc.contributor.authorMaegawa, H
dc.contributor.authorAoki, N
dc.contributor.authorNakamura, M
dc.contributor.authorKubo, N
dc.contributor.authorYamada, T
dc.contributor.authorWu, ZS
dc.contributor.authorYao, CH
dc.contributor.authorAndrews, G
dc.contributor.authorWelborn, TA
dc.contributor.authorTang, Z
dc.contributor.authorLiu, LS
dc.contributor.authorXie, JX
dc.contributor.authorNorton, R
dc.contributor.authorAmeratunga, S
dc.contributor.authorMacmahon, S
dc.contributor.authorWhitlock, G
dc.contributor.authorKnuiman, MW
dc.contributor.authorChristensen, H
dc.contributor.authorZhou, J
dc.contributor.authorYu, XH
dc.contributor.authorWu, XG
dc.contributor.authorTamakoshi, A
dc.contributor.authorPan, WH
dc.contributor.authorSritara, P
dc.contributor.authorWu, ZL
dc.contributor.authorChen, LQ
dc.contributor.authorShan, GL
dc.contributor.authorGu, DF
dc.contributor.authorDuan, XF
dc.contributor.authorJackson, R
dc.contributor.authorLi, YH
dc.contributor.authorLam, TH
dc.contributor.authorJiang, CQ
dc.contributor.authorFujishima, M
dc.contributor.authorKiyohara, Y
dc.contributor.authorIwamoto, H
dc.contributor.authorWoo, J
dc.contributor.authorHo, SC
dc.contributor.authorHong, Z
dc.contributor.authorHuang, MS
dc.contributor.authorZhou, B
dc.contributor.authorFuh, JL
dc.contributor.authorKita, Y
dc.contributor.authorChoudhury, SR
dc.contributor.authorSuh, I
dc.contributor.authorJee, SH
dc.contributor.authorKim, IS
dc.contributor.authorGiles, G
dc.contributor.authorHashimoto, T
dc.contributor.authorSakata, K
dc.contributor.authorDobson, A
dc.contributor.authorImai, Y
dc.contributor.authorOhkubo, T
dc.contributor.authorHozawa, A
dc.contributor.authorJamrozik, K
dc.contributor.authorNorman, P
dc.contributor.authorHobbs, M
dc.contributor.authorBroadhurst, R
dc.contributor.authorNakachi, K
dc.contributor.authorFang, XH
dc.contributor.authorLi, SC
dc.contributor.authorYang, QD
dc.contributor.authorChen, ZM
dc.contributor.authorTanaka, H
dc.contributor.authorNozaki, A
dc.contributor.authorHoribe, H
dc.contributor.authorMatsutani, Y
dc.contributor.authorKagaya, M
dc.contributor.authorHughes, K
dc.contributor.authorLee, J
dc.contributor.authorHeng, D
dc.contributor.authorChew, SK
dc.contributor.authorZhou, BF
dc.contributor.authorZhang, HY
dc.contributor.authorShimamoto, K
dc.contributor.authorSaito, S
dc.contributor.authorLi, ZZ
dc.contributor.authorZhang, HY
dc.contributor.authorHe, Y
dc.contributor.authorLam, TH
dc.contributor.authorYao, SX
dc.date.accessioned2012-06-26T06:25:34Z
dc.date.available2012-06-26T06:25:34Z
dc.date.issued2005
dc.description.abstractBackground: There is much interest in promoting healthy heart awareness among women. However, little is known about the reasons behind the lower rates of heart disease among women compared with men, and why this risk difference diminishes with age. Previous comparative studies have generally had insufficient numbers of women to quantify such differences reliably. Methods: We carried out an individual participant data meta-analysis of 39 cohort studies (32 from Asian countries and 7 from Australia and New Zealand). Cox models were used to estimate hazard ratios (HR) for coronary death, comparing men to women. Further adjustments were made for several proven coronary risk factors to quantify their contributions to the sex differential. Sex interactions were tested for the same risk factors. Results: During 4 million person-years of follow-up, there were 1989 (926 female) deaths from coronary heart disease (CHD). The age-adjusted and study-adjusted male/female HR (95% confidence interval [95% CI]) was 2.05 (1.89-2.22). At baseline, 54% of men vs. 7% of women were current smokers; hence, adjustment for smoking explained the largest component (20%) of this HR. A significant sex interaction was observed between systolic blood pressure (SBP) and CHD mortality such that a 10 mm Hg increase was associated with a 15% greater increase in the relative risk (RR) of coronary death in women compared with men (p = 0.002). Conclusions: Only a small amount of the sex differential in coronary death could be explained by differences in the prevalence of classic risk factors. Alternative explanations are required to explain the age-related attenuation of the sex difference in CHD risk. © Mary Ann Liebert, Inc.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationJournal Of Women's Health, 2005, v. 14 n. 9, p. 820-827 [How to Cite?]
DOI: http://dx.doi.org/10.1089/jwh.2005.14.820
dc.identifier.citeulike1990454
dc.identifier.doihttp://dx.doi.org/10.1089/jwh.2005.14.820
dc.identifier.epage827
dc.identifier.isiWOS:000234347900005
dc.identifier.issn1540-9996
2011 Impact Factor: 1.569
2011 SCImago Journal Rankings: 0.127
dc.identifier.issue9
dc.identifier.pmid16313209
dc.identifier.scopuseid_2-s2.0-29744437775
dc.identifier.spage820
dc.identifier.urihttp://hdl.handle.net/10722/151618
dc.identifier.volume14
dc.languageeng
dc.publisherMary Ann Liebert, Inc Publishers. The Journal's web site is located at http://www.liebertpub.com/jwh
dc.publisher.placeUnited States
dc.relation.ispartofJournal of Women's Health
dc.relation.referencesReferences in Scopus
dc.subject.meshAge Distribution
dc.subject.meshAged
dc.subject.meshAsia - Epidemiology
dc.subject.meshAustralia - Epidemiology
dc.subject.meshCholesterol
dc.subject.meshComorbidity
dc.subject.meshConfidence Intervals
dc.subject.meshCoronary Disease - Etiology - Mortality
dc.subject.meshDiabetes Complications - Epidemiology
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshNew Zealand - Epidemiology
dc.subject.meshObesity - Epidemiology
dc.subject.meshOdds Ratio
dc.subject.meshProportional Hazards Models
dc.subject.meshRisk Assessment
dc.subject.meshSex Distribution
dc.subject.meshSmoking - Adverse Effects - Epidemiology
dc.subject.meshWomen's Health
dc.titleDoes sex matter in the associations between classic risk factors and fatal coronary heart disease in populations from the Asia-Pacific region?
dc.typeArticle
Author Affiliations
  1. George Institute for International Health
  2. Civil Service Workers
  3. Beijing Aging
  4. Korean Medical Insurance Company
  5. Guangzhou Occupational
  6. Capital Iron and Steel Company Hospital Cohort
  7. Capital Iron and Steel Company
  8. National Heart Foundation of Australia
  9. Melbourne Cohort
  10. Beijing Steelworkers