It is well recognized that women usually experience a first cardiovascular disease (CVD) event later in life than men. Because the reasons underpinning this phenomenon are still unclear, Anand et al. from the INTERHEART study examined the distribution of CVD risk factors between men and women. The INTERHEART study is a cross-sectional study of 27,098 participants from 52 countries. In this study, women experienced their first myocardial infarction (MI) on average 9 years later than men. This study has previously highlighted the fact that 9 potentially modifiable risk factors accounted for a very large proportion of MI in this population. In the present investigation, it was found that abnormal lipids (estimated by the apolipoprotein B/apolipoprotein AI ratio), current smoking, waist-to-hip ratio, high-risk diet, and psychosocial risk factors were similarly associated with MI in women and in men. However, hypertension, diabetes, physical inactivity, and moderate alcohol use showed higher associations with MI in women than in men. In unadjusted analyses, the probability of having MI and being less than 60 years of age was 27.6% lower in women. However, after adjusting for the 9 INTERHEART risk factors, this difference dropped to 4.7%. These results suggest that the sex differences between age and first MI event are largely explained by underlying potentially modifiable risk factors.
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