Risk of Incident Coronary Heart Disease Events in Men Compared to Women by Menopause Type and Race.

Abstract

BACKGROUND:

We examined whether type of menopause affects sex differences in coronary heart disease (CHD) events and whether the impact is similar in blacks and whites.

METHODS AND RESULTS:

Participants were enrolled in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort between 2003 and 2007 without CHD at baseline (n=23 086). Cox regression models were used to calculate the hazard of incident nonfatal CHD (definite or probable myocardial infarction) and acute CHD death, adjusting for age, age at last menstrual period <45 years, region, education level, income, diabetes, smoking, systolic blood pressure, lipid levels, albumin-creatinine ratio, physical activity, C-reactive protein, body mass index, waist circumference, and medication use. White women in natural menopause (hazard ratio [HR], 0.45; 95% confidence interval [CI], 0.31, 0.66) and surgical menopause (HR, 0.65; 95% CI, 0.42, 0.99) had a reduced hazard of nonfatal events, compared to white men. Black women in natural menopause (HR, 0.69; 95% CI, 0.47, 1.03), but not surgical menopause (HR, 0.81; 95% CI, 0.51, 1.29), had a marginally reduced hazard of nonfatal events, compared to black men. Women had lower risk of acute CHD death than men regardless of their menopause type and race.

CONCLUSIONS:

Sex differences in the risk of incident CHD events were larger among whites than blacks and varied by type of menopause. Women consistently had a lower risk of incident CHD death than men, but the magnitude of sex differences was greater in whites than blacks for nonfatal events, regardless of menopause type.

• Authors: Catherine Kim, Mary Cushman, Yulia Khodneva, Lynda D Lisabeth, Suzanne Judd, Dawn O Kleindorfer, Virginia J Howard, Monika M Safford
• Journal: Journal of the American Heart Association (J Am Heart Assoc) Vol. 4 Issue 7 (Jul 01 2015) ISSN: 2047-9980 [Electronic] England
• PMID: 26133958 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Topics

• Adult
• Black or African American
• Age Factors
• Aged
• Chi-Square Distribution
• Coronary Disease (diagnosis, ethnology, mortality)
• Female
• Health Status Disparities
• Humans
• Hysterectomy
• Incidence
• Male
• Menopause (ethnology)
• Middle Aged
• Myocardial Infarction (diagnosis, ethnology, mortality)
• Ovariectomy
• Proportional Hazards Models
• Prospective Studies
• Risk Assessment
• Risk Factors
• Sex Factors
• Time Factors
• United States (epidemiology)
• White People