Sex Differences in Veterans' Cardiovascular Health

Area of Science:

• Cardiology
• Public Health
• Health Services Research

Background:

• Sex differences in cardiovascular health are established in the U.S. civilian population.
• Military service may introduce unique stressors impacting cardiovascular health in Veterans.
• Understanding these differences within the Veteran population is crucial for tailored care.

Purpose of the Study:

• To investigate sex-based differences in cardiovascular disease (CVD) risk factors and conditions among Veterans.
• To compare CVD prevalence between male and female Veterans utilizing the Department of Veterans Affairs (VA) Health Care System.
• To determine if civilian sex differences in CVD are mirrored in the Veteran population.

Main Methods:

• Retrospective analysis of VA administrative data from Fiscal Year 2014.
• Identification of CVD risk factors and conditions using International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes.
• Prevalence examination stratified by gender, age, and race/ethnicity.

Main Results:

• The cohort comprised 92.9% men (n=5,376,749) and 7.1% women (n=412,901).
• Women Veterans were younger and more ethnically diverse than men.
• Women showed lower prevalence of traditional CVD risk factors but higher prevalence of depression; they had higher odds of chest pain/angina and valvular disease, but lower odds of coronary artery disease, acute myocardial infarction, and heart failure compared to men.

Conclusions:

• Sex differences in cardiovascular risk factors and conditions among VA patients largely mirror those in the civilian population.
• Women Veterans exhibit distinct CVD profiles, including higher rates of depression and chest pain.
• These findings underscore the need for gender-specific approaches in cardiovascular care for Veterans.