TY - JOUR
T1 - Sex differences in associations of comorbidities with incident cardiovascular disease
T2 - Focus on absolute risk
AU - Dronkers, Just
AU - Meems, Laura M G
AU - van Veldhuisen, Dirk J
AU - Meyer, Sven
AU - Kieneker, Lyanne M
AU - Gansevoort, Ron T
AU - Bakker, Stephan J L
AU - Rienstra, Michiel
AU - de Boer, Rudolf A
AU - Suthahar, Navin
N1 - Publisher Copyright: © 2022 The Author(s). Published by Oxford University Press on behalf of European Society of Cardiology.
PY - 2022/3
Y1 - 2022/3
N2 - AIM: To examine sex differences in associations of obesity, type-2 diabetes, hypertension, and atrial fibrillation (AF) with incident cardiovascular disease (CVD), focusing on absolute risk measures.METHODS AND RESULTS: We included a total of 7994 individuals (mean age 49.1 years; 51.2% women) without prior CVD from the PREVEND (Prevention of Renal and Vascular End-stage Disease) cohort with a median follow-up of 12.5 years. Using Poisson regression, we calculated the increase in absolute as well as relative CVD risk associated with a comorbidity using incidence rate differences (IRD = IR comorbidity-IR no-comorbidity) and incidence rate ratios (IRR = IR comorbidity/IR no-comorbidity), respectively. Sex differences were presented as women-to-men differences (WMD = IRD women-IRD men) and women-to-men ratios (WMR = IRR women/IRR men). Absolute CVD risk was lower in women than in men (IR women: 6.73 vs. IR men: 14.58 per 1000 person-years). While increase in absolute CVD risk associated with prevalent hypertension was lower in women than in men [WMD: -6.12, 95% confidence interval: (-9.84 to -2.40), P = 0.001], increase in absolute CVD risk associated with prevalent obesity [WMD: -4.25 (-9.11 to 0.61), P = 0.087], type-2 diabetes [WMD: -1.04 (-14.36 to 12.29), P = 0.879] and AF [WMD: 18.39 (-39.65 to 76.43), P = 0.535] did not significantly differ between the sexes. Using relative risk measures, prevalent hypertension [WMR: 1.49%, 95% confidence interval: (1.12-1.99), P = 0.006], type-2 diabetes [WMR: 1.73 (1.09-2.73), P = 0.019], and AF [WMR: 2.53 (1.12-5.70), P = 0.025] were all associated with higher CVD risk in women than in men. CONCLUSION: Increase in absolute risk of developing CVD is higher in hypertensive men than in hypertensive women, but no substantial sex-related differences were observed among individuals with obesity, type-2 diabetes and AF. On a relative risk scale, comorbidities, in general, confer a higher CVD risk in women than in men.
AB - AIM: To examine sex differences in associations of obesity, type-2 diabetes, hypertension, and atrial fibrillation (AF) with incident cardiovascular disease (CVD), focusing on absolute risk measures.METHODS AND RESULTS: We included a total of 7994 individuals (mean age 49.1 years; 51.2% women) without prior CVD from the PREVEND (Prevention of Renal and Vascular End-stage Disease) cohort with a median follow-up of 12.5 years. Using Poisson regression, we calculated the increase in absolute as well as relative CVD risk associated with a comorbidity using incidence rate differences (IRD = IR comorbidity-IR no-comorbidity) and incidence rate ratios (IRR = IR comorbidity/IR no-comorbidity), respectively. Sex differences were presented as women-to-men differences (WMD = IRD women-IRD men) and women-to-men ratios (WMR = IRR women/IRR men). Absolute CVD risk was lower in women than in men (IR women: 6.73 vs. IR men: 14.58 per 1000 person-years). While increase in absolute CVD risk associated with prevalent hypertension was lower in women than in men [WMD: -6.12, 95% confidence interval: (-9.84 to -2.40), P = 0.001], increase in absolute CVD risk associated with prevalent obesity [WMD: -4.25 (-9.11 to 0.61), P = 0.087], type-2 diabetes [WMD: -1.04 (-14.36 to 12.29), P = 0.879] and AF [WMD: 18.39 (-39.65 to 76.43), P = 0.535] did not significantly differ between the sexes. Using relative risk measures, prevalent hypertension [WMR: 1.49%, 95% confidence interval: (1.12-1.99), P = 0.006], type-2 diabetes [WMR: 1.73 (1.09-2.73), P = 0.019], and AF [WMR: 2.53 (1.12-5.70), P = 0.025] were all associated with higher CVD risk in women than in men. CONCLUSION: Increase in absolute risk of developing CVD is higher in hypertensive men than in hypertensive women, but no substantial sex-related differences were observed among individuals with obesity, type-2 diabetes and AF. On a relative risk scale, comorbidities, in general, confer a higher CVD risk in women than in men.
UR - https://www.scopus.com/pages/publications/85137848202
U2 - 10.1093/ehjopen/oeac017
DO - 10.1093/ehjopen/oeac017
M3 - Article
C2 - 35919118
AN - SCOPUS:85137848202
SN - 2752-4191
VL - 2
JO - European Heart Journal Open
JF - European Heart Journal Open
IS - 2
M1 - oeac017
ER -
