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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, J5
Yu, XH5
Wu, XG7
Tamakoshi, A2
Pan, WH
Sritara, P
Wu, ZL
Chen, LQ
Shan, GL
Gu, DF
Duan, XF
Jackson, R
Li, YH
Lam, TH
Jiang, CQ6
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
2013 Impact Factor: 1.896
2013 SCImago Journal Rankings: 0.960
 
DOIhttp://dx.doi.org/10.1089/jwh.2005.14.820
 
ISI Accession Number IDWOS:000234347900005
 
ReferencesReferences in Scopus
 
DC FieldValue
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.naturePublished_or_final_version
 
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
2013 Impact Factor: 1.896
2013 SCImago Journal Rankings: 0.960
 
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.rightsCreative Commons: Attribution 3.0 Hong Kong License
 
dc.rightsThis is a copy of an article published in the [Journal of Women's Health] © [2005] [copyright Mary Ann Liebert, Inc.]; [Journal of Women's Health] is available online at: http://www.liebertonline.com.
 
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
 
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<contributor.author>Okayama, A</contributor.author>
<contributor.author>Ueshima, H</contributor.author>
<contributor.author>Maegawa, H</contributor.author>
<contributor.author>Aoki, N</contributor.author>
<contributor.author>Nakamura, M</contributor.author>
<contributor.author>Kubo, N</contributor.author>
<contributor.author>Yamada, T</contributor.author>
<contributor.author>Wu, ZS</contributor.author>
<contributor.author>Yao, CH</contributor.author>
<contributor.author>Andrews, G</contributor.author>
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<contributor.author>Fujishima, M</contributor.author>
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<contributor.author>Hong, Z</contributor.author>
<contributor.author>Huang, MS</contributor.author>
<contributor.author>Zhou, B</contributor.author>
<contributor.author>Fuh, JL</contributor.author>
<contributor.author>Kita, Y</contributor.author>
<contributor.author>Choudhury, SR</contributor.author>
<contributor.author>Suh, I</contributor.author>
<contributor.author>Jee, SH</contributor.author>
<contributor.author>Kim, IS</contributor.author>
<contributor.author>Giles, G</contributor.author>
<contributor.author>Hashimoto, T</contributor.author>
<contributor.author>Sakata, K</contributor.author>
<contributor.author>Dobson, A</contributor.author>
<contributor.author>Imai, Y</contributor.author>
<contributor.author>Ohkubo, T</contributor.author>
<contributor.author>Hozawa, A</contributor.author>
<contributor.author>Jamrozik, K</contributor.author>
<contributor.author>Norman, P</contributor.author>
<contributor.author>Hobbs, M</contributor.author>
<contributor.author>Broadhurst, R</contributor.author>
<contributor.author>Nakachi, K</contributor.author>
<contributor.author>Fang, XH</contributor.author>
<contributor.author>Li, SC</contributor.author>
<contributor.author>Yang, QD</contributor.author>
<contributor.author>Chen, ZM</contributor.author>
<contributor.author>Tanaka, H</contributor.author>
<contributor.author>Nozaki, A</contributor.author>
<contributor.author>Horibe, H</contributor.author>
<contributor.author>Matsutani, Y</contributor.author>
<contributor.author>Kagaya, M</contributor.author>
<contributor.author>Hughes, K</contributor.author>
<contributor.author>Lee, J</contributor.author>
<contributor.author>Heng, D</contributor.author>
<contributor.author>Chew, SK</contributor.author>
<contributor.author>Zhou, BF</contributor.author>
<contributor.author>Zhang, HY</contributor.author>
<contributor.author>Shimamoto, K</contributor.author>
<contributor.author>Saito, S</contributor.author>
<contributor.author>Li, ZZ</contributor.author>
<contributor.author>Zhang, HY</contributor.author>
<contributor.author>He, Y</contributor.author>
<contributor.author>Lam, TH</contributor.author>
<contributor.author>Yao, SX</contributor.author>
<date.accessioned>2012-06-26T06:25:34Z</date.accessioned>
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<date.issued>2005</date.issued>
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<identifier.issn>1540-9996</identifier.issn>
<identifier.uri>http://hdl.handle.net/10722/151618</identifier.uri>
<description.abstract>Background: 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. &#169; Mary Ann Liebert, Inc.</description.abstract>
<language>eng</language>
<publisher>Mary Ann Liebert, Inc Publishers. The Journal&apos;s web site is located at http://www.liebertpub.com/jwh</publisher>
<relation.ispartof>Journal of Women&apos;s Health</relation.ispartof>
<rights>Creative Commons: Attribution 3.0 Hong Kong License</rights>
<rights>This is a copy of an article published in the [Journal of Women&apos;s Health] &#169; [2005] [copyright Mary Ann Liebert, Inc.]; [Journal of Women&apos;s Health] is available online at: http://www.liebertonline.com.</rights>
<subject.mesh>Age Distribution</subject.mesh>
<subject.mesh>Aged</subject.mesh>
<subject.mesh>Asia - Epidemiology</subject.mesh>
<subject.mesh>Australia - Epidemiology</subject.mesh>
<subject.mesh>Cholesterol</subject.mesh>
<subject.mesh>Comorbidity</subject.mesh>
<subject.mesh>Confidence Intervals</subject.mesh>
<subject.mesh>Coronary Disease - Etiology - Mortality</subject.mesh>
<subject.mesh>Diabetes Complications - Epidemiology</subject.mesh>
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<subject.mesh>Humans</subject.mesh>
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<subject.mesh>Obesity - Epidemiology</subject.mesh>
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<subject.mesh>Risk Assessment</subject.mesh>
<subject.mesh>Sex Distribution</subject.mesh>
<subject.mesh>Smoking - Adverse Effects - Epidemiology</subject.mesh>
<subject.mesh>Women&apos;s Health</subject.mesh>
<title>Does sex matter in the associations between classic risk factors and fatal coronary heart disease in populations from the Asia-Pacific region?</title>
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Author Affiliations
  1. George Institute for International Health
  2. Civil Service Workers
  3. Beijing Aging
  4. Korean Medical Insurance Company
  5. Capital Iron and Steel Company Hospital Cohort
  6. Guangzhou Occupational
  7. Capital Iron and Steel Company
  8. National Heart Foundation of Australia
  9. Melbourne Cohort
  10. Beijing Steelworkers