Sex differences in risk factors for myocardial infarction: cohort study of UK Biobank participants

<h4>Objectives</h4> <p>To investigate sex differences in risk factor associations with incident myocardial infarction (MI) and whether these vary by age.</p> <h4>Design</h4> <p>Prospective population based study.</p> <h4>Setting</h4> <p...

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Main Authors: Millett, E, Peters, S, Woodward, M
Format: Journal article
Published: BMJ Publishing Group 2018
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author Millett, E
Peters, S
Woodward, M
author_facet Millett, E
Peters, S
Woodward, M
author_sort Millett, E
collection OXFORD
description <h4>Objectives</h4> <p>To investigate sex differences in risk factor associations with incident myocardial infarction (MI) and whether these vary by age.</p> <h4>Design</h4> <p>Prospective population based study.</p> <h4>Setting</h4> <p>UK Biobank</p> <h4>Participants</h4> <p>471,998 participants, (56% women; mean age 56.2 years) with no history of cardiovascular disease.</p> <h4>Main outcome measures</h4> <p>Incident (fatal and non-fatal) MI.</p> <h4>Results</h4> <p>5,081 participants (29% women) experienced MI over seven years mean follow-up, resulting in incidence rates of 7.76/10,000 person years (95% CI 7.37 to 8.16) among women and 24.35/10,000 (23.57 to 25.16) among men. In both sexes, higher blood pressure (BP) indices, smoking intensity, and body mass index, and the presence of diabetes were associated with an increased risk of MI, but associations were attenuated with age. Compared with men, women had an excess HR of MI for systolic BP and hypertension, smoking status and intensity, and diabetes: ratio of HRs (95% CIs) were 1.09 (1.02 to 1.16) for systolic BP, 1.55 (1.32 to 1.83) for current smoking, and 2.91 (1.56 to 5.45) for type I and 1.47 (1.16 to 1.87) for type II diabetes. There was no evidence of attenuation of any of these RHRs with age (p&gt;0.2). With the exception of type I diabetes, for all risk factors, and for every category of those risk factors, men had higher rates of MI than women.</p> <h4>Conclusions</h4> <p>Rates of MI are higher among men than women. However, several major risk factors for MI confer an excess relative risk of MI among women compared with men. With ageing, sex-specific associations decline but, where it occurs, the female disadvantage in relative risk persists. Over time, population ageing, coupled with the increasing prevalence of lifestyle-associated risk factors, is likely to result in women having a more similar rate of MI to men.</p>
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spelling oxford-uuid:82d3a267-cbb8-4244-a522-036db9084de22022-03-26T21:40:04ZSex differences in risk factors for myocardial infarction: cohort study of UK Biobank participantsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:82d3a267-cbb8-4244-a522-036db9084de2Symplectic Elements at OxfordBMJ Publishing Group2018Millett, EPeters, SWoodward, M <h4>Objectives</h4> <p>To investigate sex differences in risk factor associations with incident myocardial infarction (MI) and whether these vary by age.</p> <h4>Design</h4> <p>Prospective population based study.</p> <h4>Setting</h4> <p>UK Biobank</p> <h4>Participants</h4> <p>471,998 participants, (56% women; mean age 56.2 years) with no history of cardiovascular disease.</p> <h4>Main outcome measures</h4> <p>Incident (fatal and non-fatal) MI.</p> <h4>Results</h4> <p>5,081 participants (29% women) experienced MI over seven years mean follow-up, resulting in incidence rates of 7.76/10,000 person years (95% CI 7.37 to 8.16) among women and 24.35/10,000 (23.57 to 25.16) among men. In both sexes, higher blood pressure (BP) indices, smoking intensity, and body mass index, and the presence of diabetes were associated with an increased risk of MI, but associations were attenuated with age. Compared with men, women had an excess HR of MI for systolic BP and hypertension, smoking status and intensity, and diabetes: ratio of HRs (95% CIs) were 1.09 (1.02 to 1.16) for systolic BP, 1.55 (1.32 to 1.83) for current smoking, and 2.91 (1.56 to 5.45) for type I and 1.47 (1.16 to 1.87) for type II diabetes. There was no evidence of attenuation of any of these RHRs with age (p&gt;0.2). With the exception of type I diabetes, for all risk factors, and for every category of those risk factors, men had higher rates of MI than women.</p> <h4>Conclusions</h4> <p>Rates of MI are higher among men than women. However, several major risk factors for MI confer an excess relative risk of MI among women compared with men. With ageing, sex-specific associations decline but, where it occurs, the female disadvantage in relative risk persists. Over time, population ageing, coupled with the increasing prevalence of lifestyle-associated risk factors, is likely to result in women having a more similar rate of MI to men.</p>
spellingShingle Millett, E
Peters, S
Woodward, M
Sex differences in risk factors for myocardial infarction: cohort study of UK Biobank participants
title Sex differences in risk factors for myocardial infarction: cohort study of UK Biobank participants
title_full Sex differences in risk factors for myocardial infarction: cohort study of UK Biobank participants
title_fullStr Sex differences in risk factors for myocardial infarction: cohort study of UK Biobank participants
title_full_unstemmed Sex differences in risk factors for myocardial infarction: cohort study of UK Biobank participants
title_short Sex differences in risk factors for myocardial infarction: cohort study of UK Biobank participants
title_sort sex differences in risk factors for myocardial infarction cohort study of uk biobank participants
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AT peterss sexdifferencesinriskfactorsformyocardialinfarctioncohortstudyofukbiobankparticipants
AT woodwardm sexdifferencesinriskfactorsformyocardialinfarctioncohortstudyofukbiobankparticipants