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ABSTRACT: Objectives
To investigate sex differences in risk factors for incident myocardial infarction (MI) and whether they vary with age.Design
Prospective population based study.Setting
UK Biobank.Participants
471?998 participants (56% women; mean age 56.2) with no history of cardiovascular disease.Main outcome measure
Incident (fatal and non-fatal) MI.Results
5081 participants (1463 (28.8%) of whom were women) had MI over seven years' mean follow-up, resulting in an incidence per 10?000 person years of 7.76 (95% confidence interval 7.37 to 8.16) for women and 24.35 (23.57 to 25.16) for men. Higher blood pressure indices, smoking intensity, body mass index, and the presence of diabetes were associated with an increased risk of MI in men and women, but associations were attenuated with age. In women, systolic blood pressure and hypertension, smoking status and intensity, and diabetes were associated with higher hazard ratios for MI compared with men: ratio of hazard ratios 1.09 (95% confidence interval 1.02 to 1.16) for systolic blood pressure, 1.55 (1.32 to 1.83) for current smoking, 2.91 (1.56 to 5.45) for type 1 diabetes, and 1.47 (1.16 to 1.87) for type 2 diabetes. There was no evidence that any of these ratios of hazard ratios decreased with age (P>0.2). With the exception of type 1 diabetes, the incidence of MI was higher in men than in women for all risk factors.Conclusions
Although the incidence of MI was higher in men than in women, several risk factors were more strongly associated with MI in women compared with men. Sex specific associations between risk factors and MI declined with age, but, where it occurred, the higher relative risk in women remained. As the population ages and the prevalence of lifestyle associated risk factors increase, the incidence of MI in women will likely become more similar to that in men.
SUBMITTER: Millett ERC
PROVIDER: S-EPMC6364292 | biostudies-literature | 2018 Nov
REPOSITORIES: biostudies-literature
Millett Elizabeth R C ERC Peters Sanne A E SAE Woodward Mark M
BMJ (Clinical research ed.) 20181107
<h4>Objectives</h4>To investigate sex differences in risk factors for incident myocardial infarction (MI) and whether they vary with age.<h4>Design</h4>Prospective population based study.<h4>Setting</h4>UK Biobank.<h4>Participants</h4>471 998 participants (56% women; mean age 56.2) with no history of cardiovascular disease.<h4>Main outcome measure</h4>Incident (fatal and non-fatal) MI.<h4>Results</h4>5081 participants (1463 (28.8%) of whom were women) had MI over seven years' mean follow-up, res ...[more]