Article: Does sex matter in the associations between classic risk factors and fatal coronary heart disease in populations from the Asia-Pacific region?
| Title | Does sex matter in the associations between classic risk factors and fatal coronary heart disease in populations from the Asia-Pacific region? |
|---|---|
| Authors | Huxley, 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 Date | 2005 |
| Publisher | Mary Ann Liebert, Inc Publishers. The Journal's web site is located at http://www.liebertpub.com/jwh |
| Citation | Journal 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 |
| 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. © Mary Ann Liebert, Inc. |
| ISSN | 1540-9996 2011 Impact Factor: 1.569 2011 SCImago Journal Rankings: 0.127 |
| DOI | http://dx.doi.org/10.1089/jwh.2005.14.820 |
| ISI Accession Number ID | WOS:000234347900005 |
| References | References in Scopus |
| dc.contributor.author | Huxley, R |
|---|---|
| dc.contributor.author | Okayama, A |
| dc.contributor.author | Ueshima, H |
| dc.contributor.author | Maegawa, H |
| dc.contributor.author | Aoki, N |
| dc.contributor.author | Nakamura, M |
| dc.contributor.author | Kubo, N |
| dc.contributor.author | Yamada, T |
| dc.contributor.author | Wu, ZS |
| dc.contributor.author | Yao, CH |
| dc.contributor.author | Andrews, G |
| dc.contributor.author | Welborn, TA |
| dc.contributor.author | Tang, Z |
| dc.contributor.author | Liu, LS |
| dc.contributor.author | Xie, JX |
| dc.contributor.author | Norton, R |
| dc.contributor.author | Ameratunga, S |
| dc.contributor.author | Macmahon, S |
| dc.contributor.author | Whitlock, G |
| dc.contributor.author | Knuiman, MW |
| dc.contributor.author | Christensen, H |
| dc.contributor.author | Zhou, J |
| dc.contributor.author | Yu, XH |
| dc.contributor.author | Wu, XG |
| dc.contributor.author | Tamakoshi, A |
| dc.contributor.author | Pan, WH |
| dc.contributor.author | Sritara, P |
| dc.contributor.author | Wu, ZL |
| dc.contributor.author | Chen, LQ |
| dc.contributor.author | Shan, GL |
| dc.contributor.author | Gu, DF |
| dc.contributor.author | Duan, XF |
| dc.contributor.author | Jackson, R |
| dc.contributor.author | Li, YH |
| dc.contributor.author | Lam, TH |
| dc.contributor.author | Jiang, CQ |
| dc.contributor.author | Fujishima, M |
| dc.contributor.author | Kiyohara, Y |
| dc.contributor.author | Iwamoto, H |
| dc.contributor.author | Woo, J |
| dc.contributor.author | Ho, SC |
| dc.contributor.author | Hong, Z |
| dc.contributor.author | Huang, MS |
| dc.contributor.author | Zhou, B |
| dc.contributor.author | Fuh, JL |
| dc.contributor.author | Kita, Y |
| dc.contributor.author | Choudhury, SR |
| dc.contributor.author | Suh, I |
| dc.contributor.author | Jee, SH |
| dc.contributor.author | Kim, IS |
| dc.contributor.author | Giles, G |
| dc.contributor.author | Hashimoto, T |
| dc.contributor.author | Sakata, K |
| dc.contributor.author | Dobson, A |
| dc.contributor.author | Imai, Y |
| dc.contributor.author | Ohkubo, T |
| dc.contributor.author | Hozawa, A |
| dc.contributor.author | Jamrozik, K |
| dc.contributor.author | Norman, P |
| dc.contributor.author | Hobbs, M |
| dc.contributor.author | Broadhurst, R |
| dc.contributor.author | Nakachi, K |
| dc.contributor.author | Fang, XH |
| dc.contributor.author | Li, SC |
| dc.contributor.author | Yang, QD |
| dc.contributor.author | Chen, ZM |
| dc.contributor.author | Tanaka, H |
| dc.contributor.author | Nozaki, A |
| dc.contributor.author | Horibe, H |
| dc.contributor.author | Matsutani, Y |
| dc.contributor.author | Kagaya, M |
| dc.contributor.author | Hughes, K |
| dc.contributor.author | Lee, J |
| dc.contributor.author | Heng, D |
| dc.contributor.author | Chew, SK |
| dc.contributor.author | Zhou, BF |
| dc.contributor.author | Zhang, HY |
| dc.contributor.author | Shimamoto, K |
| dc.contributor.author | Saito, S |
| dc.contributor.author | Li, ZZ |
| dc.contributor.author | Zhang, HY |
| dc.contributor.author | He, Y |
| dc.contributor.author | Lam, TH |
| dc.contributor.author | Yao, SX |
| dc.date.accessioned | 2012-06-26T06:25:34Z |
| dc.date.available | 2012-06-26T06:25:34Z |
| dc.date.issued | 2005 |
| dc.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. © Mary Ann Liebert, Inc. |
| dc.description.nature | Link_to_subscribed_fulltext |
| dc.identifier.citation | Journal 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.citeulike | 1990454 |
| dc.identifier.doi | http://dx.doi.org/10.1089/jwh.2005.14.820 |
| dc.identifier.epage | 827 |
| dc.identifier.isi | WOS:000234347900005 |
| dc.identifier.issn | 1540-9996 2011 Impact Factor: 1.569 2011 SCImago Journal Rankings: 0.127 |
| dc.identifier.issue | 9 |
| dc.identifier.pmid | 16313209 |
| dc.identifier.scopus | eid_2-s2.0-29744437775 |
| dc.identifier.spage | 820 |
| dc.identifier.uri | http://hdl.handle.net/10722/151618 |
| dc.identifier.volume | 14 |
| dc.language | eng |
| dc.publisher | Mary Ann Liebert, Inc Publishers. The Journal's web site is located at http://www.liebertpub.com/jwh |
| dc.publisher.place | United States |
| dc.relation.ispartof | Journal of Women's Health |
| dc.relation.references | References in Scopus |
| dc.subject.mesh | Age Distribution |
| dc.subject.mesh | Aged |
| dc.subject.mesh | Asia - Epidemiology |
| dc.subject.mesh | Australia - Epidemiology |
| dc.subject.mesh | Cholesterol |
| dc.subject.mesh | Comorbidity |
| dc.subject.mesh | Confidence Intervals |
| dc.subject.mesh | Coronary Disease - Etiology - Mortality |
| dc.subject.mesh | Diabetes Complications - Epidemiology |
| dc.subject.mesh | Female |
| dc.subject.mesh | Humans |
| dc.subject.mesh | Male |
| dc.subject.mesh | Middle Aged |
| dc.subject.mesh | New Zealand - Epidemiology |
| dc.subject.mesh | Obesity - Epidemiology |
| dc.subject.mesh | Odds Ratio |
| dc.subject.mesh | Proportional Hazards Models |
| dc.subject.mesh | Risk Assessment |
| dc.subject.mesh | Sex Distribution |
| dc.subject.mesh | Smoking - Adverse Effects - Epidemiology |
| dc.subject.mesh | Women's Health |
| dc.title | Does sex matter in the associations between classic risk factors and fatal coronary heart disease in populations from the Asia-Pacific region? |
| dc.type | Article |
Author Affiliations
- George Institute for International Health
- Civil Service Workers
- Beijing Aging
- Korean Medical Insurance Company
- Guangzhou Occupational
- Capital Iron and Steel Company Hospital Cohort
- Capital Iron and Steel Company
- National Heart Foundation of Australia
- Melbourne Cohort
- Beijing Steelworkers

