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Sex differences in risk factors for coronary heart disease events: a prospective cohort study in Iran

Azra Ramezankhani1, Fereidoun Azizi2, Farzad Hadaegh3

  • 1Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Scientific Reports
|December 16, 2023
PubMed

Insights

Major cardiovascular risk factors like hypertension and diabetes pose a greater risk for coronary heart disease (CHD) events in Iranian women than men. This highlights the need for targeted prevention strategies for women.

Area of Science:

  • Cardiology
  • Epidemiology
  • Public Health

Background:

  • Cardiovascular diseases (CVDs) remain a leading cause of mortality globally.
  • Sex-specific differences in CVD risk factor associations are increasingly recognized.
  • Understanding these differences is crucial for effective, tailored prevention strategies.

Purpose of the Study:

  • To investigate sex-specific associations between major cardiovascular risk factors and incident coronary heart disease (CHD).
  • To compare the risk of hard CHD (nonfatal myocardial infarction and CHD death) between men and women.
  • To identify risk factors conferring a disproportionately higher risk in women.

Main Methods:

  • Analysis of 7518 participants (3377 men) from the Tehran Lipid and Glucose Study.
  • Prospective follow-up for 20 years (1999-2018) to document CHD and hard CHD events.
  • Cox proportional hazards models used to estimate hazard ratios (HRs) and women-to-men ratios of HRs.

Main Results:

  • Hypertension, diabetes, pre-diabetes, and high waist-to-hip ratio (WHR) showed significantly greater HRs for hard CHD in women compared to men.
  • Women-to-men HR ratios were 2.85 for hypertension, 1.92 for diabetes, 2.04 for pre-diabetes, and 1.42 for high WHR.
  • Diabetes was also associated with a higher HR for overall CHD in women (ratio of HRs 1.49).

Conclusions:

  • Hypertension, diabetes, pre-diabetes, and high WHR confer a greater excess risk of CHD events in Iranian women than in men.
  • These findings suggest that Iranian women may warrant greater attention for cardiovascular disease prevention.
  • Sex-specific risk factor assessment is essential for optimizing cardiovascular health strategies.

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