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The Effect of Cardiovascular Comorbidities on Women Compared to Men: Longitudinal Retrospective Analysis
Elma Dervic1,2, Carola Deischinger3, Nils Haug1,2
1Section for Science of Complex Systems, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
Insights
While cardiovascular disease (CVD) is more common in men, women face greater risks from associated conditions like diabetes and nicotine dependence. This study highlights sex-based differences in CVD comorbidities.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Cardiovascular disease (CVD) affects men more frequently than women.
- Certain CVD risk factors, including nicotine abuse and diabetes mellitus, disproportionately impact women's health outcomes.
- Understanding sex-specific risk factor associations is crucial for targeted CVD prevention strategies.
Purpose of the Study:
- To develop and apply a systematic method for analyzing population-wide electronic health records.
- To comprehensively screen for all possible comorbidities associated with acute myocardial infarction (AMI) and chronic ischemic heart disease (CHD).
- To identify comorbidities with significantly different prevalence between men and women in relation to CVD.
Main Methods:
- Utilized a population-wide medical claims dataset of 44 million inpatient stays in Austria (2003-2014).
- Determined comorbidities of AMI (ICD-10 code I21) and CHD (ICD-10 code I25).
- Quantified sex differences in comorbidity prevalence using logarithmic odds ratios (ORs) and pooled standard errors.
Main Results:
- Except for lipid metabolism disorders, most identified comorbidities were more strongly associated with AMI and CHD in women than in men.
- Significantly higher odds ratios (ORs) for women were observed for nicotine dependence, diabetes mellitus, obesity, renal disorders, asthma, and COPD.
- These findings were consistent for both AMI and CHD, indicating a greater impact of these comorbidities on cardiovascular risk in females.
Conclusions:
- Despite higher overall prevalence of AMI and CHD in men, women experience a more pronounced effect from specific comorbidities.
- These sex-specific differences in comorbidity associations underscore the need for tailored approaches in CVD risk assessment and management.
- The study provides valuable insights into the complex interplay between sex, comorbidities, and cardiovascular disease risk.
Background:
Although men are more prone to developing cardiovascular disease (CVD) than women, risk factors for CVD, such as nicotine abuse and diabetes mellitus, have been shown to be more detrimental in women than in men.
Objective:
We developed a method to systematically investigate population-wide electronic health records for all possible associations between risk factors for CVD and other diagnoses. The developed structured approach allows an exploratory and comprehensive screening of all possible comorbidities of CVD, which are more connected to CVD in either men or women.
Methods:
Based on a population-wide medical claims dataset comprising 44 million records of inpatient stays in Austria from 2003 to 2014, we determined comorbidities of acute myocardial infarction (AMI; International Classification of Diseases, Tenth Revision [ICD-10] code I21) and chronic ischemic heart disease (CHD; ICD-10 code I25) with a significantly different prevalence in men and women. We introduced a measure of sex difference as a measure of differences in logarithmic odds ratios (ORs) between male and female patients in units of pooled standard errors.
Results:
Except for lipid metabolism disorders (OR for females [ORf]=6.68, 95% confidence interval [CI]=6.57-6.79, OR for males [ORm]=8.31, 95% CI=8.21-8.41), all identified comorbidities were more likely to be associated with AMI and CHD in females than in males: nicotine dependence (ORf=6.16, 95% CI=5.96-6.36, ORm=4.43, 95% CI=4.35-4.5), diabetes mellitus (ORf=3.52, 95% CI=3.45-3.59, ORm=3.13, 95% CI=3.07-3.19), obesity (ORf=3.64, 95% CI=3.56-3.72, ORm=3.33, 95% CI=3.27-3.39), renal disorders (ORf=4.27, 95% CI=4.11-4.44, ORm=3.74, 95% CI=3.67-3.81), asthma (ORf=2.09, 95% CI=1.96-2.23, ORm=1.59, 95% CI=1.5-1.68), and COPD (ORf=2.09, 95% CI 1.96-2.23, ORm=1.59, 95% CI 1.5-1.68). Similar results could be observed for AMI.
Conclusions:
Although AMI and CHD are more prevalent in men, women appear to be more affected by certain comorbidities of AMI and CHD in their risk for developing CVD.
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