Men developed CVD earlier than women, according to 35-year CARDIA study
Long-term data from the CARDIA (Coronary Artery Risk Development in Young Adults) study confirms sex differences in cardiovascular disease (CVD) risk emerge by age 35, with men developing atherosclerosis earlier than women. The conformation of cardiovascular disease risk differences emerging in the fourth decade of life supports the movement toward earlier cardiovascular screening and prevention efforts.
"Men developed CVD on average seven years earlier than women. For stroke and heart failure, age of onset and 10‐year event rates were similar for men and women," wrote lead author Alexa A. Freedman, PhD, Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine.
The CARDIA study includes 5,112 participants with a mean age of 24.8 years that were recruited between 1985 and 1986 and followed over the course of their lives to collect data on the progression of CVD. This new study looked at the data up to 2020.
Men reached 5% incidence of CVD seven years earlier than women. Coronary heart disease being the most frequent subtype, with men reaching 2% incidence about 10.1 years earlier than women. But the researchers found men and women reached 2% stroke and 1% heart failure incidence at similar ages.
"Our finding that men reach a cumulative incidence of coronary heart disease 10 years earlier than women is consistent with the well‐established and commonly stated age gap. Although this gap has been reported for decades, our findings highlight that temporal trends in cardiometabolic risk factors or increases in premature CVD have not affected the sex difference in coronary heart disease," Freedman, et al, wrote.
The authors said there has been an increasing interest in beginning screening and prevention efforts earlier than age 40 or 50, and this study supports those efforts. They noted the development of American Heart Association risk prediction calculator equations for cardiovascular events now enable prediction of CVD risk starting from age 30.
"Promoting preventive care among young adult men may be a key opportunity to prioritize CVD prevention in this critical life period. However, this study does not intend to diminish the importance of CVD prevention in women, as CVD is the leading cause of mortality and premature death in women," the authors wrote.
The CARDIA study only included Black and white participants, so the researchers said and results may not generalize to other groups.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]