Cardiovascular
Sex-Specific Differences in Premature Cardiovascular Disease Subtypes in Adults from East Asia Yuichiro Mori* Yuichiro Mori Mori Mori Mori Mori Mori Mori Mori Kyoto University Graduate School of Medicine
Background: While it is well-established that women experience atherosclerotic cardiovascular disease (ASCVD) at later ages compared with men, sex-specific data on premature onset of heart failure (HF) and its antecedent risk factors, are limited. This is of unique interest in East Asia where rapid epidemiologic transitions are shifting the burden of cardiovascular disease.
Methods: This bi-national cohort study used data from the Japan Health Insurance Association (JHIA) and the Korean National Health Insurance Service (KNHIS). We included adults aged 35–59 years at baseline without prior ASCVD or HF. The primary outcome was premature CVD defined as ASCVD or HF occurring before age 65. We calculated differences by sex in the age-of-onset with cumulative incidence functions. We also calculated hazard ratios (HRs) by sex for traditional risk factors and incident CVD using Cox proportional hazards models and evaluated differences in these associations between women and men.
Results: Among 5,442,337 participants in the JHIA and 5,226,414 participants in the KNHIS, mean age was 46.2 (7.0) and 46.7 (6.7) years, and 33.2% and 42.6% were women, respectively. Women developed incident premature CVD 11.4 years and 7.3 years later than men in the JHIA and the KNHIS, respectively, with similar patterns for ASCVD and HF. Traditional risk factors were significantly associated with premature ASCVD and HF in both sexes. Notably, the magnitude of association between each risk factor and HF was largely similar for women and men.
Conclusions: While women experience HF at older ages compared with men, antecedent risk factors and the magnitude of association between traditional risk factors and HF were largely similar underscoring prioritization of preventive efforts earlier in the life course for both women and men.
