During the past decade, substantial attention has been directed toward sex differences in heart disease outcomes. Two research groups report recent trends in cardiovascular disease (CVD) risk and myocardial infarction (MI) outcomes.
In the first study, investigators assessed data from more than 8000 participants (age range, 35–54) in the National Health and Nutrition Examination Survey (1988–1994 and 1999–2004). Comparison of Framingham Risk Scores during the two periods showed that mean scores improved among men but worsened among women. In men, total cholesterol levels remained stable, HDL cholesterol levels and blood pressure improved, and smoking rates declined. In women, only HDL levels improved. Prevalence of diabetes rose in both sexes. During both periods, more men than women of comparable age experienced MIs; however, MI prevalence fell among men and rose among women (2.5% and 2.2% in men vs. 0.7% and 1.0% in women during 1988–1994 and 1999–2004, respectively).
In the second study, researchers determined trends in rates of in-hospital post-MI deaths from June 1, 1994, to December 31, 2006, based on data from nearly 1 million patients in the National Registry of Myocardial Infarction. In-hospital death rates fell among all patients, but the decline was more marked in women than in men. The reduction in in-hospital mortality was greatest in women who were younger than 55 (52.9% reduction). The absolute rate of decrease was three times larger in women (2.7%) than in men (0.9%). A substantial portion of this decrease in mortality was attributed to improved risk status at presentation in women compared with men.
