The risk factors for cardiovascular disease are largely the same in women and men, a study shows

The risk factors for cardiovascular disease are largely the same in women and men, a study shows

The risk factors for cardiovascular disease are largely the same in women and men, as a comprehensive global study involving the University of Gothenburg shows.

The study, now published in The Lancet, includes participants from both high- and middle- and low-income countries. Cardiovascular diseases are more common in the latter. Data come from the Prospective Urban Rural Epidemiological (PURE) Study.

155,724 people in 21 countries on five continents took part in the study. The participants, aged 35 to 70, had no history of cardiovascular disease at the time they were enrolled in the study. All cases of fatal cardiovascular disease, heart attack, stroke and heart failure were recorded during the follow-up period, which was an average of ten years.

The risk factors examined were metabolic (such as hypertension, obesity and diabetes), behavioral (tobacco smoking and diet) and psychosocial (economic status and depression).

No clear gender or income separation

Metabolic risk factors were found to be similar in both sexes, with the exception of high levels of low-density lipoprotein (LDL, often known as bad cholesterol), where the association with cardiovascular disease was stronger in men. However, according to the researchers, this finding needs to be confirmed in further studies.

Depressive symptoms were another risk factor for cardiovascular disease, which was more important in men than in women. In women, however, the connection between poor nutrition and cardiovascular disease was closer; and smoking was an equally harmful risk factor for women, although it was significantly more common in men.

Overall, the researchers found broadly similar risk factors for cardiovascular disease among male and female participants, regardless of their country's income level. This also highlights the importance of disease prevention strategies that are consistent for both genders.

Similarities are greater than differences

Women's lower overall risk of cardiovascular disease, particularly heart attack (myocardial infarction), may be explained by younger women's higher tolerance to risk factors. Their estrogen makes the blood vessel walls more flexible and impairs the liver's ability to excrete LDL.

Among the women in the study (90,934 people), 5.0 cases of stroke, heart attack and/or cardiovascular disease were registered per 1,000 people per year. The corresponding number in the men's group (64,790 people) was 8.2 cases.

Annika Rosengren, professor of medicine at Sahlgrenska Academy, University of Gothenburg, is the second author of the study and is responsible for the Swedish part of the PURE population study with 4,000 people in Gothenburg and Skaraborg.

When it comes to cardiovascular diseases in men and women, the similarities in terms of risk factors are significantly greater than the differences. However, men are more prone to high levels of LDL, the bad cholesterol, and from other studies we know that they develop pathological changes in the coronary arteries at a younger age than women and tend to develop a heart attack much earlier. However, in early stroke, the sex differences are less pronounced, as we have also seen in other studies.”

Annika Rosengren, Professor of Medicine at Sahlgrenska Academy, University of Gothenburg

Source:

University of Gothenburg

Reference:

Walli-Attaei, M., et al. (2022) Metabolic, behavioral and psychosocial risk factors and cardiovascular disease in women compared to men in 21 high-, middle- and low-income countries: an analysis of the PURE study. The lancet. doi.org/10.1016/S0140-6736(22)01441-6.