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Sex differences in the epidemiology and outcomes of heart disease: population-based trends

V V Roger1, S J Jacobsen, S A Weston

  • 1Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.

Lupus
|August 24, 1999
PubMed

Insights

Heart disease mortality declined significantly between 1979 and 1994, but the decline was less pronounced in women and older adults. Women also received less cardiac care compared to men, suggesting potential disparities in treatment.

Area of Science:

  • Cardiovascular epidemiology
  • Public health
  • Gerontology

Background:

  • Heart disease (HD) remains a leading cause of mortality globally.
  • Understanding temporal trends in HD mortality and treatment is crucial for effective public health interventions.
  • Olmsted County, MN, provides a unique population for studying long-term health trends.

Purpose of the Study:

  • To examine trends in heart disease mortality and cardiac care delivery in Olmsted County, MN, between 1979 and 1994.
  • To identify potential disparities in HD mortality and treatment between genders and age groups.

Main Methods:

  • Retrospective analysis of heart disease mortality data (ICD9 codes 390-398, 402, 404-429) from 1979 to 1994.
  • Calculation of age-adjusted mortality rates and risk ratios (RR) for HD death.
  • Comparison of cardiac care utilization (stress tests, cardiology visits, cardiac procedures) between men and women presenting with unstable angina.

Main Results:

  • Women accounted for 51% of total HD deaths (3095) during the study period.
  • Age-adjusted HD mortality rate declined from 123 to 81 per 100,000, with a greater decline in men (4.2%/y) than women (2.5%/y).
  • The decline in HD mortality was less pronounced in older age groups, indicating a growing burden of HD in women and the elderly. Women utilized stress tests, post-stress cardiology visits, and cardiac procedures less frequently than men, particularly those presenting with unstable angina.

Conclusions:

  • Heart disease mortality rates declined overall, but trends suggest a shifting burden towards women and the elderly.
  • Disparities in the utilization of cardiac care exist between men and women, particularly for unstable angina.
  • Further research is warranted to investigate the causal relationships between observed trends in mortality, care delivery, and patient demographics.

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