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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?

TitleDoes sex matter in the associations between classic risk factors and fatal coronary heart disease in populations from the Asia-Pacific region?
Authors
Issue Date2005
PublisherMary 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?
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.
Persistent Identifierhttp://hdl.handle.net/10722/151618
ISSN
2013 Impact Factor: 1.896
2013 SCImago Journal Rankings: 0.960
ISI Accession Number ID
References

 

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
DC FieldValueLanguage
dc.contributor.authorHuxley, Ren_US
dc.contributor.authorOkayama, Aen_US
dc.contributor.authorUeshima, Hen_US
dc.contributor.authorMaegawa, Hen_US
dc.contributor.authorAoki, Nen_US
dc.contributor.authorNakamura, Men_US
dc.contributor.authorKubo, Nen_US
dc.contributor.authorYamada, Ten_US
dc.contributor.authorWu, ZSen_US
dc.contributor.authorYao, CHen_US
dc.contributor.authorAndrews, Gen_US
dc.contributor.authorWelborn, TAen_US
dc.contributor.authorTang, Zen_US
dc.contributor.authorLiu, LSen_US
dc.contributor.authorXie, JXen_US
dc.contributor.authorNorton, Ren_US
dc.contributor.authorAmeratunga, Sen_US
dc.contributor.authorMacmahon, Sen_US
dc.contributor.authorWhitlock, Gen_US
dc.contributor.authorKnuiman, MWen_US
dc.contributor.authorChristensen, Hen_US
dc.contributor.authorZhou, Jen_US
dc.contributor.authorYu, XHen_US
dc.contributor.authorWu, XGen_US
dc.contributor.authorTamakoshi, Aen_US
dc.contributor.authorPan, WHen_US
dc.contributor.authorSritara, Pen_US
dc.contributor.authorWu, ZLen_US
dc.contributor.authorChen, LQen_US
dc.contributor.authorShan, GLen_US
dc.contributor.authorGu, DFen_US
dc.contributor.authorDuan, XFen_US
dc.contributor.authorJackson, Ren_US
dc.contributor.authorLi, YHen_US
dc.contributor.authorLam, THen_US
dc.contributor.authorJiang, CQen_US
dc.contributor.authorFujishima, Men_US
dc.contributor.authorKiyohara, Yen_US
dc.contributor.authorIwamoto, Hen_US
dc.contributor.authorWoo, Jen_US
dc.contributor.authorHo, SCen_US
dc.contributor.authorHong, Zen_US
dc.contributor.authorHuang, MSen_US
dc.contributor.authorZhou, Ben_US
dc.contributor.authorFuh, JLen_US
dc.contributor.authorKita, Yen_US
dc.contributor.authorChoudhury, SRen_US
dc.contributor.authorSuh, Ien_US
dc.contributor.authorJee, SHen_US
dc.contributor.authorKim, ISen_US
dc.contributor.authorGiles, Gen_US
dc.contributor.authorHashimoto, Ten_US
dc.contributor.authorSakata, Ken_US
dc.contributor.authorDobson, Aen_US
dc.contributor.authorImai, Yen_US
dc.contributor.authorOhkubo, Ten_US
dc.contributor.authorHozawa, Aen_US
dc.contributor.authorJamrozik, Ken_US
dc.contributor.authorNorman, Pen_US
dc.contributor.authorHobbs, Men_US
dc.contributor.authorBroadhurst, Ren_US
dc.contributor.authorNakachi, Ken_US
dc.contributor.authorFang, XHen_US
dc.contributor.authorLi, SCen_US
dc.contributor.authorYang, QDen_US
dc.contributor.authorChen, ZMen_US
dc.contributor.authorTanaka, Hen_US
dc.contributor.authorNozaki, Aen_US
dc.contributor.authorHoribe, Hen_US
dc.contributor.authorMatsutani, Yen_US
dc.contributor.authorKagaya, Men_US
dc.contributor.authorHughes, Ken_US
dc.contributor.authorLee, Jen_US
dc.contributor.authorHeng, Den_US
dc.contributor.authorChew, SKen_US
dc.contributor.authorZhou, BFen_US
dc.contributor.authorZhang, HYen_US
dc.contributor.authorShimamoto, Ken_US
dc.contributor.authorSaito, Sen_US
dc.contributor.authorLi, ZZen_US
dc.contributor.authorZhang, HYen_US
dc.contributor.authorHe, Yen_US
dc.contributor.authorLam, THen_US
dc.contributor.authorYao, SXen_US
dc.date.accessioned2012-06-26T06:25:34Z-
dc.date.available2012-06-26T06:25:34Z-
dc.date.issued2005en_US
dc.identifier.citationJournal Of Women's Health, 2005, v. 14 n. 9, p. 820-827en_US
dc.identifier.issn1540-9996en_US
dc.identifier.urihttp://hdl.handle.net/10722/151618-
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.en_US
dc.languageengen_US
dc.publisherMary Ann Liebert, Inc Publishers. The Journal's web site is located at http://www.liebertpub.com/jwhen_US
dc.relation.ispartofJournal of Women's Healthen_US
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 Distributionen_US
dc.subject.meshAgeden_US
dc.subject.meshAsia - Epidemiologyen_US
dc.subject.meshAustralia - Epidemiologyen_US
dc.subject.meshCholesterolen_US
dc.subject.meshComorbidityen_US
dc.subject.meshConfidence Intervalsen_US
dc.subject.meshCoronary Disease - Etiology - Mortalityen_US
dc.subject.meshDiabetes Complications - Epidemiologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNew Zealand - Epidemiologyen_US
dc.subject.meshObesity - Epidemiologyen_US
dc.subject.meshOdds Ratioen_US
dc.subject.meshProportional Hazards Modelsen_US
dc.subject.meshRisk Assessmenten_US
dc.subject.meshSex Distributionen_US
dc.subject.meshSmoking - Adverse Effects - Epidemiologyen_US
dc.subject.meshWomen's Healthen_US
dc.titleDoes sex matter in the associations between classic risk factors and fatal coronary heart disease in populations from the Asia-Pacific region?en_US
dc.typeArticleen_US
dc.identifier.emailLam, TH:hrmrlth@hkucc.hku.hken_US
dc.identifier.emailLam, TH:hrmrlth@hkucc.hku.hken_US
dc.identifier.authorityLam, TH=rp00326en_US
dc.identifier.authorityLam, TH=rp00326en_US
dc.description.naturepublished_or_final_versionen_US
dc.identifier.doi10.1089/jwh.2005.14.820en_US
dc.identifier.pmid16313209en_US
dc.identifier.scopuseid_2-s2.0-29744437775en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-29744437775&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume14en_US
dc.identifier.issue9en_US
dc.identifier.spage820en_US
dc.identifier.epage827en_US
dc.identifier.isiWOS:000234347900005-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridHuxley, R=6701828350en_US
dc.identifier.scopusauthoridOkayama, A=35300529100en_US
dc.identifier.scopusauthoridUeshima, H=7005129002en_US
dc.identifier.scopusauthoridMaegawa, H=7005198303en_US
dc.identifier.scopusauthoridAoki, N=7401716495en_US
dc.identifier.scopusauthoridNakamura, M=7405343309en_US
dc.identifier.scopusauthoridKubo, N=7102513194en_US
dc.identifier.scopusauthoridYamada, T=7405975512en_US
dc.identifier.scopusauthoridWu, ZS=7501411359en_US
dc.identifier.scopusauthoridYao, CH=7201495948en_US
dc.identifier.scopusauthoridAndrews, G=7202160860en_US
dc.identifier.scopusauthoridWelborn, TA=7005408607en_US
dc.identifier.scopusauthoridTang, Z=7403305634en_US
dc.identifier.scopusauthoridLiu, LS=7405259104en_US
dc.identifier.scopusauthoridXie, JX=7402994954en_US
dc.identifier.scopusauthoridNorton, R=18344863600en_US
dc.identifier.scopusauthoridAmeratunga, S=6701716378en_US
dc.identifier.scopusauthoridMacMahon, S=24312201200en_US
dc.identifier.scopusauthoridWhitlock, G=7004159442en_US
dc.identifier.scopusauthoridKnuiman, MW=7005404334en_US
dc.identifier.scopusauthoridChristensen, H=7401664499en_US
dc.identifier.scopusauthoridZhou, J=35228239600en_US
dc.identifier.scopusauthoridYu, XH=7404114656en_US
dc.identifier.scopusauthoridWu, XG=7407065596en_US
dc.identifier.scopusauthoridTamakoshi, A=7006797376en_US
dc.identifier.scopusauthoridPan, WH=7402219783en_US
dc.identifier.scopusauthoridSritara, P=6602366631en_US
dc.identifier.scopusauthoridWu, ZL=15053584200en_US
dc.identifier.scopusauthoridChen, LQ=10040762900en_US
dc.identifier.scopusauthoridShan, GL=7005942365en_US
dc.identifier.scopusauthoridGu, DF=7202151958en_US
dc.identifier.scopusauthoridDuan, XF=7202708945en_US
dc.identifier.scopusauthoridJackson, R=7404309778en_US
dc.identifier.scopusauthoridLi, YH=23667749400en_US
dc.identifier.scopusauthoridLam, TH=7202522876en_US
dc.identifier.scopusauthoridJiang, CQ=10639500500en_US
dc.identifier.scopusauthoridFujishima, M=35352934700en_US
dc.identifier.scopusauthoridKiyohara, Y=7005335984en_US
dc.identifier.scopusauthoridIwamoto, H=7202028291en_US
dc.identifier.scopusauthoridWoo, J=36040369400en_US
dc.identifier.scopusauthoridHo, SC=7403716908en_US
dc.identifier.scopusauthoridHong, Z=7201414497en_US
dc.identifier.scopusauthoridHuang, MS=8902885500en_US
dc.identifier.scopusauthoridZhou, B=7401906952en_US
dc.identifier.scopusauthoridFuh, JL=35227302000en_US
dc.identifier.scopusauthoridKita, Y=7202729333en_US
dc.identifier.scopusauthoridChoudhury, SR=7102715678en_US
dc.identifier.scopusauthoridSuh, I=7101988200en_US
dc.identifier.scopusauthoridJee, SH=16039275900en_US
dc.identifier.scopusauthoridKim, IS=36079546600en_US
dc.identifier.scopusauthoridGiles, G=7103091133en_US
dc.identifier.scopusauthoridHashimoto, T=15759516300en_US
dc.identifier.scopusauthoridSakata, K=7402050385en_US
dc.identifier.scopusauthoridDobson, A=34667612000en_US
dc.identifier.scopusauthoridImai, Y=36050693700en_US
dc.identifier.scopusauthoridOhkubo, T=7201618716en_US
dc.identifier.scopusauthoridHozawa, A=7003868341en_US
dc.identifier.scopusauthoridJamrozik, K=26426193300en_US
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dc.identifier.scopusauthoridNakachi, K=8749947000en_US
dc.identifier.scopusauthoridFang, XH=15834725000en_US
dc.identifier.scopusauthoridLi, SC=7409237355en_US
dc.identifier.scopusauthoridYang, QD=7404076103en_US
dc.identifier.scopusauthoridChen, ZM=7409483946en_US
dc.identifier.scopusauthoridTanaka, H=8724909300en_US
dc.identifier.scopusauthoridNozaki, A=7006414963en_US
dc.identifier.scopusauthoridHoribe, H=7005739955en_US
dc.identifier.scopusauthoridMatsutani, Y=8892298100en_US
dc.identifier.scopusauthoridKagaya, M=7006577657en_US
dc.identifier.scopusauthoridHughes, K=7202448794en_US
dc.identifier.scopusauthoridLee, J=36064197700en_US
dc.identifier.scopusauthoridHeng, D=6701509730en_US
dc.identifier.scopusauthoridChew, SK=7202524627en_US
dc.identifier.scopusauthoridZhou, BF=7401907215en_US
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dc.identifier.scopusauthoridLam, TH=7202522876en_US
dc.identifier.scopusauthoridYao, SX=35231647800en_US
dc.identifier.citeulike1990454-

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