Both Sexes Have Comparable Risk Factors for Cardiovascular Disease

In an extensive study of over 150,000 individuals, researchers in Sweden have found that the risk of developing cardiovascular disease is equal for both sexes.  Conducted by a team at University of Gothenburg and published in The Lancet, the research used data from the Prospective Urban Rural Epidemiological (PURE) Study and included risk factors such as metabolic (high blood pressure, obesity, and diabetes), behavioral (tobacco smoking and diet), and psychosocial (economic status and depression).

 “When it comes to cardiovascular disease in men and women, the similarities in terms of risk factors are considerably greater than the differences. But men are more vulnerable to high levels of LDL, the bad cholesterol, and we know from other studies that they develop pathological changes in the coronary arteries at a lower age than women and tend to start developing myocardial infarction quite a lot earlier. With respect to early stroke, though, the sex differences are less pronounced, as we’ve also seen in other studies,” says Annika Rosengren, Professor of Medicine at Sahlgrenska Academy, University of Gothenburg. 

The Lancet study comprised 155,724 individuals from 21 countries—both high income and medium- and low-income—covering five continents. Aged 35–70 years, the participants had no history of cardiovascular disease when they joined the study. All cases of fatal cardiovascular disease, heart attack, stroke, and heart failure during the follow-up period, which averaged ten years, were registered.

Overall, the researchers found broadly similar risk factors for cardiovascular disease for the male and female participants, irrespective of their countries’ income level. This highlights the importance of disease prevention strategies, too, being the same for both sexes.

Among the women in the study (90,934 individuals), 5.0 cases of stroke, heart attack, and/or cardiovascular disease were registered per 1,000 persons per year. The corresponding number in the group of men (64,790 individuals) was 8.2 cases.

Metabolic risk factors were found to be similar in both sexes, except for high values of low-density lipoprotein (LDL)—often known as bad cholesterol—where the association with cardiovascular disease was stronger in men. In the researchers’ opinion, however, this finding needs confirmation in more studies.

Women’s lower overall risk of cardiovascular disease, especially heart attack, may be explained by the younger women's higher tolerance to risk factors. Their estrogen makes vessel walls more compliant and affects the liver's capacity to get rid of LDL.

Depressive symptoms were a risk factor for cardiovascular disease that proved to be more significant among the men than the women. On the other hand, the link between a poor diet and cardiovascular disease was closer in women; and smoking, though markedly more frequent among men, was just as injurious a risk factor for women.