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Total cholesterol as a risk factor for coronary heart disease and stroke in women compared with men: A systematic

Sanne A E Peters1, Yankuba Singhateh2, Diana Mackay2

  • 1The George Institute for Global Health, University of Oxford, Oxford, United Kingdom.

Atherosclerosis
|March 27, 2016
PubMed

Insights

Men have a significantly stronger association between high total cholesterol and coronary heart disease risk compared to women. High total cholesterol showed little impact on stroke risk in either sex.

Area of Science:

  • Cardiology
  • Epidemiology
  • Public Health

Background:

  • Elevated total cholesterol is a significant risk factor for cardiovascular disease (CVD).
  • Existing research has not clarified potential sex-based differences in the association between total cholesterol and CVD outcomes.

Purpose of the Study:

  • To investigate sex-specific differences in the relationship between total cholesterol and the risk of coronary heart disease (CHD) and total stroke.
  • To quantify the association of total cholesterol levels with cardiovascular outcomes in men and women.

Main Methods:

  • A systematic literature search of PubMed was conducted up to December 2014.
  • Random effects meta-analyses were employed to calculate pooled sex-specific relative risks (RR) and women-to-men ratios of RRs (RRRs) for CHD and stroke.

Main Results:

  • Analysis included 97 cohorts, over 1 million individuals, and 20,176 CHD and 13,067 stroke cases.
  • A 1-mmol/L increase in total cholesterol showed a slightly stronger association with CHD risk in men (RR=1.24) than in women (RR=1.20).
  • High total cholesterol was linked to a reduced risk of CHD and stroke when comparing the highest to lowest cholesterol categories in both sexes.

Conclusions:

  • Raised total cholesterol poses a greater risk for CHD in men compared to women.
  • The impact of elevated total cholesterol on the risk of total stroke was minimal and similar in both men and women.
Abstract

Keywords:
Coronary heart diseaseMenMeta-analysisStrokeSystematic reviewTotal cholesterolWomen

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