Sex Differences in Cardiovascular Health Status and Long-Term Outcomes in a Primary Prevention Cohort

Area of Science:

• Cardiology
• Public Health
• Sex Differences in Health

Background:

• Poor cardiovascular health, defined by 8 key factors, is linked to cardiovascular disease (CVD).
• Existing research has not clarified if this association varies between men and women.

Purpose of the Study:

• To investigate if the relationship between cardiovascular health status and incident CVD events differs by sex.
• To provide evidence for tailored public health interventions.

Main Methods:

• Analysis of 175,098 adults from the Ontario Health Study (2009-2017) without prior CVD.
• Cardiovascular health assessed via ideal diet, sleep, physical activity, smoking, body mass index, blood glucose, cholesterol, and blood pressure.
• Cox proportional hazards models used to evaluate associations between health status and CVD events, with interaction terms for sex.

Main Results:

• Women had higher rates of ideal cardiovascular health (9.1%) than men (4.6%), and lower rates of poor cardiovascular health (21.9% vs. 30.5%).
• The hazard ratio for CVD was significantly higher for women with intermediate (2.31) and poor (5.08) cardiovascular health compared to men (1.57 and 2.54, respectively).
• A significant interaction term (P < 0.01) indicated a greater relative impact of declining cardiovascular health on CVD risk in women.

Conclusions:

• Declining cardiovascular health status has a greater relative impact on future CVD rates in women compared to men.
• Findings support the development of sex-specific health promotion strategies to enhance cardiovascular health and improve outcomes.