Gender and CVD- Does It Really Matters?

Suman, Satyam; Pravalika, Jakkula; Manjula, Pulluru; Farooq, Umar

doi:10.1016/j.cpcardiol.2023.101604

Cited by 31 publications

(10 citation statements)

References 36 publications

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“…This result also corresponds to previous data and may be, in part, due to biological factors such as genes and hormones [ 44 , 45 ] but this link is still not properly understood. Moreover, CVD is still under-recognised and untreated in women [ 46 ]. An in-depth exploration of gender differences and the potential impact of biological factors on CVD risk in women would enhance the discussion.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with cardiovascular disease: A comparative study of the UK Asian diaspora and residents of India

Patel,

Uthman

2024

PLoS ONE

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Introduction The aim of this paper is to investigate what factors are associated to cardiovascular disease and what differences exists between Asians living in the UK (from the English Longitudinal Study of Ageing) and the Asians living in India (from the Longitudinal Ageing Study in India). Methods Logistic regression was used to investigate how demographic and physical performance factors were associated with cardiovascular disease using data from Wave 6 of the English Longitudinal Study of Ageing and Wave 1 of the Longitudinal Study of Ageing in India, with the main variable of interest being country of residence, Asians in England or Asians in India. Results A total of 83,997 participants were included in the analyses. In the primary analysis, 73,396 participants from LASI were compared to 171 Asians in ELSA. After adjusting for age, blood pressure, resting heart rate, sex, waist circumference, gait, handgrip strength and standing balance, there was a statistically significant difference for the outcome of CVD between Whites ELSA (reference) and the participants of LASI (odds ratio = 0.77; 95% confidence interval = 0.60 to 0.99). There were no significant differences in CVD between the LASI participants, Asian ELSA, and the Non-White but not Asian ELSA groups. Discussion No difference was found between Asians that live in India compared to ethnic minorities living in England, including Asians, after adjusting for confounders, but was found between Whites in ELSA compared to LASI participants. A key limitation was the massive disparity in sample sizes between the ELSA subgroups and LASI. Further work is required where comparable sample sizes and longitudinal analyses allow trends to be identified and to investigate the factors associated with the difference in CVD between two similar ethnicities living in distinct locations. Conclusion After adjusting for risk factors, there was no difference in CVD between localised Asians and the ethnic minorities in the UK, but there was a difference between the majority ethnicities in the respective countries.

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Section: Discussionmentioning

confidence: 99%

Factors associated with cardiovascular disease: A comparative study of the UK Asian diaspora and residents of India

Patel,

Uthman

2024

PLoS ONE

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“…This is a very relevant issue since inequities in the care of women with suspected or confirmed CVD have been described. 10 In the ARIC study, McGinn et al found that the delay time to assistance for women with acute CVD has not decreased over the past 20 years, and this lack of improvement may be contributing to poor outcomes improvement in this group of patients. Digital health technologies have been proposed to improve accessibility to care in patient pathways.…”

Section: Discussionmentioning

confidence: 99%

“…To date, very limited data are available on the impact of e‐consultation programmes on clinical outcomes, and there is no published information on the gender influence, to our knowledge. This is a very relevant issue since inequities in the care of women with suspected or confirmed CVD have been described 10 …”

Section: Discussionmentioning

confidence: 99%

“…However, these factors are not included in primary prevention risk stratification tools 9 . There is ongoing debate regarding whether there are still inequities in diagnosis and disease management, 10,11 leading to gender disparities in outcomes among female patients with suspected or confirmed CVD 12 . Women attending primary healthcare services in Australia were less likely than men to have risk factors measured and recorded, which may impact their outcomes 13 …”

Section: Introductionmentioning

confidence: 99%

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Gender differences on healthcare accessibility and outcomes of a electronic inter‐clinician consultation program at the cardiology department in a Galician Health Area

Mazón‐Ramos

Aldana

Garcia‐Vega

et al. 2023

Eur J Clin Investigation

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AimsTo assess the longer‐term results (hospital admissions and mortality) in women versus men referred to a cardiology department from primary care using an e‐consultation in our outpatient care programme.MethodsWe selected 61,306 patients (30,312 women and 30,994 men) who visited the cardiology service at least once between 2010 and 2021: 69.1% (19,997 women and 20,462 men) were attended in e‐consultation (from 2013 to 2021) and 30.9% (8920 women and 9136 men) in in‐person consultations (from 2010 to 2012) without gender differences in the proportion of patients attended in each period. Using an interrupted time series regression model, we analysed the impact of incorporating e‐consultation into the healthcare model and evaluated the elapsed time to cardiology care, heart failure (HF), cardiovascular (CV), and all‐cause hospital admissions and mortality during the one‐year after cardiology consultation.ResultsThe introduction of e‐consultation substantially decreased waiting times to cardiology care; during the in‐person consultation period, the mean delay for cardiology care was 57.9 (24.8) days in men and 55.8 (22.8) days in women. During the e‐consultation period, the waiting time to cardiology care was markedly reduced to 9.41 (4.02) days in men and 9.46 (4.18) in women. After e‐consultation implantation, there was a significant reduction in the 1‐year rate of hospital admissions and mortality, both in women and men iRR [IC 95%]: 0.95 [0.93–0.96] for HF, 0.90 [0.89–0.91] for CV and 0.70 [0.69–0.71] for all‐cause hospitalization; and 0.93 [0.92–0.95] for HF, 0.86 [0.86–0.87] for CV and 0.88 [0.87–0.89] for all‐cause mortality in women; and 0.91 [0.89–0.92] for HF, 0.90 [0.89–0.91] for CV and 0.72 [0.71–0.73] for all‐cause hospitalization; and 0.96 [0.93–0.97] for HF, 0.87 [95% CI: 0.86–0.87] for CV and 0.87 [0.86–0.87] for all‐cause mortality, in men.ConclusionCompared with the in‐person consultation period, an outpatient care programme that includes an e‐consultation significantly reduced waiting time to cardiology care and was safe, with a lower rate of hospital admissions and mortality in the first year, without significative gender differences.

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“…Although animal studies have veri ed that hormones have an effect on CAD, animals do not have SDOH [27,28], so it is not feasible to use the results of animal experiments to speculate about the effect of hormones on CAD in humans. Furthermore, clinical studies have shown inconsistent results in the association between female hormones and CAD among women because of overlooked SDOH factors or the limited number of female cases included [29][30][31]. Observational studies have suggested that long-term menopausal hormone therapy (MHT) has favorable effects on several CAD risk factors and reduces CAD incidence [32].…”

Section: Introductionmentioning

confidence: 99%

Association between the female hormone intake and coronary artery disease in the women: A study based on NHANES 1999-2020

Qu,

Zhang,

et al. 2023

Preprint

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Although many studies have reported the relationship between female hormone intake and the coronary artery disease(CAD) development their association has not been elucidated and defined. Based on data from the Third National Health and Nutrition Examination Survey, this study assessed the relation between female hormone intake and the CAD development in 38745 eligible female participants. Many sociocultural determinants of health (SDOH) factors are significantly related to CAD occurrence and female hormone intake. Stratified analysis of SDOH factors showed that female hormone intake reduces the risk of CAD in women aged ≥ 60 years old. For women who received higher levels of education, female hormone intake is a risk factor for CAD. For women in poverty or wealth, female hormone intake is a risk factor for congestive heart failure and stroke, but it is a protective factor for the four clinical features of CAD for women in middle-income levels. Moreover, for women with menarche at 13–15 years old, menopause at 30–49 years old, and pregnancies 7–9 times, as well as with a low-sugar, low-fat, low-cholesterol diet and proper folic acid intake, female hormone intake have a protective effect on the development of CAD. We conclude that the appropriate female hormone intake plays a protective role in the occurrence of CAD, but it also exerts an adverse effect on CAD under a different SDOH background. It suggested that the patients must be rigorously screened for SODH background in clinical applications of female hormones to exert a protective effect on CAD.

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Gender and CVD- Does It Really Matters?

Cited by 31 publications

References 36 publications

Factors associated with cardiovascular disease: A comparative study of the UK Asian diaspora and residents of India

Factors associated with cardiovascular disease: A comparative study of the UK Asian diaspora and residents of India

Gender differences on healthcare accessibility and outcomes of a electronic inter‐clinician consultation program at the cardiology department in a Galician Health Area

Association between the female hormone intake and coronary artery disease in the women: A study based on NHANES 1999-2020

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