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Risk factor clustering in men and women with CHD in the Southern Cone of Latin America
Anna Marzà-Florensa1, Laura Gutierrez2, Pablo Gulayin2
1Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Insights
Women with coronary heart disease (CHD) have a higher burden of multiple cardiovascular risk factors (RF), particularly those with lower education. These findings highlight the need for targeted interventions to reduce cardiovascular morbidity and mortality in this population.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Multiple cardiovascular risk factors (RF) significantly increase the risk of cardiovascular morbidity and mortality, especially in patients with established coronary heart disease (CHD).
- Investigating sex differences in the prevalence of multiple cardiovascular RF is crucial for understanding disease burden in specific populations.
Purpose of the Study:
- To examine sex differences in the number and types of cardiovascular risk factors among individuals with established CHD.
- To identify common risk factor combinations and analyze the influence of educational level on these sex disparities.
Main Methods:
- Cross-sectional analysis of 634 participants (aged 35-74) with CHD from the CESCAS Study.
- Prevalence calculation for cardiometabolic and lifestyle RF, with statistical testing for sex differences using age-adjusted Poisson regression.
- Subgroup analysis based on educational attainment.
Main Results:
- Women exhibited a higher number of overall and cardiometabolic RF compared to men (RR 1.05 and 1.17, respectively).
- Specific RF like obesity, central obesity, diabetes, and low physical activity were more prevalent in women; unhealthy diet and excessive alcohol consumption were more common in men.
- Sex differences in RF burden were more pronounced in individuals with primary education and diminished in those with higher education.
Conclusions:
- Women with CHD generally present with a greater burden of multiple cardiovascular risk factors.
- Educational level significantly modifies the observed sex differences, with women of lower educational attainment bearing the highest RF burden.
- Findings underscore the importance of considering sex and socioeconomic factors in cardiovascular risk management strategies.
Background:
Presence of multiple risk factors (RF) increases the risk for cardiovascular morbidity and mortality, and this is especially important in patients with coronary heart disease (CHD). The current study investigates sex differences in the presence of multiple cardiovascular RF in subjects with established CHD in the southern Cone of Latin America.
Methods:
We analyzed cross-sectional data from the 634 participants aged 35-74 with CHD from the community-based CESCAS Study. We calculated the prevalence for counts of cardiometabolic (hypertension, dyslipidemia, obesity, diabetes) and lifestyle (current smoking, unhealthy diet, low physical activity, excessive alcohol consumption) RF. Differences in RF number between men and women were tested with age-adjusted Poisson regression. We identified the most common RF combinations among participants with ≥4 RF. We performed a subgroup analysis by educational level.
Results:
The prevalence of cardiometabolic RF ranged from 76.3% (hypertension) to 26.8% (diabetes), and the prevalence of lifestyle RF from 81.9% (unhealthy diet) to 4.3% (excessive alcohol consumption). Obesity, central obesity, diabetes and low physical activity were more common in women, while excessive alcohol consumption and unhealthy diet were more common in men. Close to 85% of women and 81.5% of men presented with ≥4 RF. Women presented with a higher number of overall (relative risk (RR) 1.05, 95% CI 1.02-1.08) and cardiometabolic RF (1.17, 1.09-1.25). These sex differences were found in participants with primary education (RR women overall RF 1.08, 1.00-1.15, cardiometabolic RF 1.23, 1.09-1.39), but were diluted in those with higher educational attainment. The most common RF combination was hypertension/dyslipidemia/obesity/unhealthy diet.
Conclusion:
Overall, women showed a higher burden of multiple cardiovascular RF. Sex differences persisted in participants with low educational attainment, and women with low educational level had the highest RF burden.
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