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Relationship between sexual differences and cardiovascular risk factors in the prevalence of asymptomatic coronary

Yong-Hoon Yoon1, Gyung-Min Park2, Jong-Young Lee3

  • 1Department of Cardiology, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, Sejong, South Korea.

International Journal of Cardiology
|November 22, 2022
PubMed

Insights

Men have a higher prevalence of coronary artery disease (CAD) than women in asymptomatic individuals. However, women with multiple cardiovascular risk factors exhibit a CAD prevalence similar to that of men.

Area of Science:

  • Cardiology
  • Radiology
  • Preventive Medicine

Background:

  • Coronary artery disease (CAD) prevalence and risk factors differ between sexes.
  • Investigating these differences in asymptomatic populations is crucial for targeted prevention.

Purpose of the Study:

  • To compare CAD prevalence and its association with cardiovascular risk factors between men and women in an asymptomatic cohort.
  • To determine if the influence of cardiovascular risk factors on CAD varies by sex.

Main Methods:

  • Coronary computed tomography angiography (CCTA) was performed on 6434 asymptomatic participants (1740 women, 4694 men).
  • Prevalence of significant CAD (diameter stenosis ≥50%) and CCTA findings were compared by sex.
  • Analysis stratified participants by the number of cardiovascular risk factors (age, hypertension, diabetes, dyslipidemia, smoking).

Main Results:

  • Men had higher prevalence of smoking, hypertension, and diabetes.
  • Coronary atherosclerosis burden indices, including coronary artery calcium score, were significantly higher in men.
  • Significant CAD prevalence was 3.7% in women and 9.1% in men (adjusted OR 2.38).
  • Higher CAD risk in men was pronounced with fewer risk factors, diminishing as risk factors increased.
  • The interaction between sex and risk factor count on CAD prevalence was significant (P < 0.001).

Conclusions:

  • Asymptomatic men exhibit significantly higher CAD prevalence compared to asymptomatic women.
  • Women with a substantial number of cardiovascular risk factors present a CAD prevalence comparable to men.
  • Risk stratification for CAD should consider sex-specific interactions with cardiovascular risk factors.
Abstract

Keywords:
AsymptomaticCoronary artery diseaseCoronary computed tomography angiographyRisk factorSex

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