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Prevalence of Cardiovascular Risk Factors in Women With Obstructive Coronary Disease Requiring Revascularization: A
Léa Berbach1,2, Claudia Nelsa Atongfor Nguéfack1,2, Brian J Potter1,2,3
1Faculty of Medicine, University of Montreal, Montréal, Québec, Canada.
Insights
Women undergoing cardiovascular procedures like coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) have higher rates of hypertension and diabetes compared to men. This highlights a critical disparity in cardiovascular risk factors for women.
Area of Science:
- Cardiology
- Vascular Surgery
- Epidemiology
Background:
- Cardiovascular disease (CVD) is a leading cause of premature death in women, a demographic historically underrepresented in clinical trials.
- Women undergoing coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) exhibit greater baseline cardiovascular risk factors, increased postprocedural complications, and higher mortality rates than men.
Purpose of the Study:
- To conduct a comprehensive analysis comparing the prevalence of individual cardiovascular risk factors between men and women undergoing revascularization procedures.
Main Methods:
- A meta-analysis was performed on original investigations involving adult subjects who underwent surgical intervention or PCIs.
- Cardiovascular risk factors were evaluated using data from MEDLINE, Cochrane, EBMR, Ovid Embase, Google Scholar, and PubMed databases.
Main Results:
- The analysis included 18 studies, revealing a high prevalence of hypertension (CABG: 71%, PCI: 59%) and diabetes (CABG: 48%, PCI: 43%) in women.
- Women had significantly higher odds of hypertension (OR 1.92 for CABG, OR 1.86 for PCI) and diabetes (OR 1.94 for CABG, OR 1.97 for PCI) compared to men.
- Conversely, the prevalence of smoking was lower in women undergoing these procedures (CABG: 0.17, PCI: 0.22).
Conclusions:
- Women undergoing either CABG or PCI demonstrate a significantly higher likelihood of having hypertension and diabetes when compared to men.
- These findings underscore the need for sex-specific considerations in the management and risk assessment of cardiovascular disease in women.
Background:
Cardiovascular disease continues to be the primary cause of premature mortality in women, who previously have been overlooked in clinical trials. Several studies showed that women undergoing coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) present more cardiovascular risk factors at baseline, develop more postprocedural complications, and have a higher mortality rate than men. The goal of this review is to analyze the difference between men and women in terms of the prevalence of individual cardiovascular risk factors.
Methods:
A meta-analysis was conducted of original investigations with adult subjects who underwent surgical intervention or PCIs in which cardiovascular risk factors were evaluated, using the MEDLINE, Cochrane, Evidence-Based Medicine Reviews (EBMR), Ovid Embase, Google Scholar, and PubMed databases.
Results:
Of the 4567 identified records found, 18 were retained for qualitative analysis. Prevalence of hypertension (CABG: 71% (95% confidence interval [CI] 64%, 78%]); PCI: (59% [95% CI 48%,70%]), and diabetes (CABG: 48% [95% CI 38%, 57%]); PCI 43% (95% CI 27%, 59%]) was high in women. Women who underwent either CABG or PCI had higher odds of having hypertension (CABG: odds ratio [OR] 1.92 [95% CI 1.47-2.50], P < 0.05); PCI: OR 1.86 [95% CI 1.76-1.97], P < 0.05]), and diabetes (CABG: OR 1.94 [95% CI 1.55-2.42], P < 0.05; PCI: OR 1.97 [95% CI 1.54-2.53], P < 0.05)). However, the prevalence of smoking among women, compared to men, was lower (CABG: 0.17 [95% CI 0.06-0.52], P < 0.05; PCI: 0.22 [95% CI 0.06-0.86], P < 0.03).
Conclusion:
The review shows that women who underwent either surgical or percutaneous revascularization had higher odds of hypertension and diabetes, compared to men.
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