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Risk factors for myocardial infarction in women and men: insights from the INTERHEART study.
Eur Heart J. 2008 Apr; 29(7):932-40.EH

Abstract

AIMS

Coronary heart disease (CHD) is a leading cause of death among men and women globally. Women develop CHD about 10 years later than men, yet the reasons for this are unclear. The purpose of this report is to determine if differences in risk factor distributions exist between women and men across various age categories to help explain why women develop acute MI later than men.

METHODS AND RESULTS

We used the INTERHEART global case-control study including 27 098 participants from 52 countries, 6787 of whom were women. The median age of first acute MI was higher in women than men (65 vs. 56 years; P < 0.0001). Nine modifiable risk factors were associated with MI in women and men. Hypertension [2.95(2.66 -3.28) vs. 2.32(2.16-2.48)], diabetes [4.26(3.68-4.94) vs. 2.67(2.43-2.94), physical activity [0.48(0.41-0.57) vs. 0.77(0.71-0.83)], and moderate alcohol use [0.41(0.34-0.50) vs. 0.88(0.82-0.94)] were more strongly associated with MI among women than men. The association of abnormal lipids, current smoking, abdominal obesity, high risk diet, and psychosocial stress factors with MI was similar in women and men. Risk factors associations were generally stronger among younger individuals compared to older women and men. The population attributable risk (PAR) of all nine risk factors exceeded 94%, and was similar among women and men (96 vs. 93%). Men were significantly more likely to suffer a MI prior to 60 years of age than were women, however, after adjusting for levels of risk factors, the sex difference in the probability of MI cases occurring before the age of 60 years was reduced by more than 80%.

CONCLUSION

Women experience their first acute MI on average 9 years later than men. Nine modifiable risk factors are significantly associated with acute MI in both men and women and explain greater than 90% of the PAR. The difference in age of first MI is largely explained by the higher risk factor levels at younger ages in men compared to women.

Authors+Show Affiliations

Population Health Research Institute, McMaster University, Hamilton, ON, Canada. anands@mcmaster.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18334475

Citation

Anand, Sonia S., et al. "Risk Factors for Myocardial Infarction in Women and Men: Insights From the INTERHEART Study." European Heart Journal, vol. 29, no. 7, 2008, pp. 932-40.
Anand SS, Islam S, Rosengren A, et al. Risk factors for myocardial infarction in women and men: insights from the INTERHEART study. Eur Heart J. 2008;29(7):932-40.
Anand, S. S., Islam, S., Rosengren, A., Franzosi, M. G., Steyn, K., Yusufali, A. H., Keltai, M., Diaz, R., Rangarajan, S., & Yusuf, S. (2008). Risk factors for myocardial infarction in women and men: insights from the INTERHEART study. European Heart Journal, 29(7), 932-40. https://doi.org/10.1093/eurheartj/ehn018
Anand SS, et al. Risk Factors for Myocardial Infarction in Women and Men: Insights From the INTERHEART Study. Eur Heart J. 2008;29(7):932-40. PubMed PMID: 18334475.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for myocardial infarction in women and men: insights from the INTERHEART study. AU - Anand,Sonia S, AU - Islam,Shofiqul, AU - Rosengren,Annika, AU - Franzosi,Maria Grazia, AU - Steyn,Krisela, AU - Yusufali,Afzal Hussein, AU - Keltai,Matyas, AU - Diaz,Rafael, AU - Rangarajan,Sumathy, AU - Yusuf,Salim, AU - ,, Y1 - 2008/03/10/ PY - 2008/3/13/pubmed PY - 2008/11/14/medline PY - 2008/3/13/entrez SP - 932 EP - 40 JF - European heart journal JO - Eur. Heart J. VL - 29 IS - 7 N2 - AIMS: Coronary heart disease (CHD) is a leading cause of death among men and women globally. Women develop CHD about 10 years later than men, yet the reasons for this are unclear. The purpose of this report is to determine if differences in risk factor distributions exist between women and men across various age categories to help explain why women develop acute MI later than men. METHODS AND RESULTS: We used the INTERHEART global case-control study including 27 098 participants from 52 countries, 6787 of whom were women. The median age of first acute MI was higher in women than men (65 vs. 56 years; P < 0.0001). Nine modifiable risk factors were associated with MI in women and men. Hypertension [2.95(2.66 -3.28) vs. 2.32(2.16-2.48)], diabetes [4.26(3.68-4.94) vs. 2.67(2.43-2.94), physical activity [0.48(0.41-0.57) vs. 0.77(0.71-0.83)], and moderate alcohol use [0.41(0.34-0.50) vs. 0.88(0.82-0.94)] were more strongly associated with MI among women than men. The association of abnormal lipids, current smoking, abdominal obesity, high risk diet, and psychosocial stress factors with MI was similar in women and men. Risk factors associations were generally stronger among younger individuals compared to older women and men. The population attributable risk (PAR) of all nine risk factors exceeded 94%, and was similar among women and men (96 vs. 93%). Men were significantly more likely to suffer a MI prior to 60 years of age than were women, however, after adjusting for levels of risk factors, the sex difference in the probability of MI cases occurring before the age of 60 years was reduced by more than 80%. CONCLUSION: Women experience their first acute MI on average 9 years later than men. Nine modifiable risk factors are significantly associated with acute MI in both men and women and explain greater than 90% of the PAR. The difference in age of first MI is largely explained by the higher risk factor levels at younger ages in men compared to women. SN - 0195-668X UR - https://www.unboundmedicine.com/medline/citation/18334475/Risk_factors_for_myocardial_infarction_in_women_and_men:_insights_from_the_INTERHEART_study_ L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehn018 DB - PRIME DP - Unbound Medicine ER -