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MI in recent decades increased in midlife women
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The prevalence of MI as assessed with the Framingham coronary risk score increased in recent decades among midlife women but decreased in midlife men, study results suggested.
Researchers enrolled participants from two epochs of the National Health and Nutritional Examination Survey, with 4,326 from the NHANES 1988-1994 period and 4,075 from the NHANES 1999-2004 period. They then assessed the sex-specific prevalence of MI and the Framingham coronary risk scores of the study population.
Men aged 35 to 54 years had a higher prevalence of MI in both the NHANES 1988-1994 cohort (2.5% vs. 0.7%; P<.01) and in the NHANES 1999-2004 cohort (2.2% vs. 1.0%; P<.01). The prevalence of a Framingham coronary risk score >20% declined in men aged 45 to 54 years between NHANES epochs (16% in 1988-1994 to 10.6% in 1999-2004; P=.01) but remained stable for women in this age group (0.5% in 1988-1994 to 0.6% in 1999-2004; P=.78). When the age groups were collapsed, men’s mean Framingham coronary risk scores showed an improving trend (8.6% in 1988-1994 to 8.1% in 1999-2004; P=.07), whereas women’s mean scores worsened (3% in 1988-1994 to 3.3% in 1999-2004; P=.02).
Sex-specific trends in Framingham coronary risk score components varied. Men improved in all components except for total cholesterol, which remained stable, and diabetes prevalence, which increased. Fewer improvements were observed among women, who remained stable in all components except for an increase in mean HDL levels. Diabetes prevalence also increased in women.
“In support of what seems to be an ominous trend in CV health among midlife women, evaluation of the Framingham coronary risk score, a reliable indicator of future risk of CHD, revealed that although the Framingham coronary risk score remains higher in men than in women, the difference has narrowed,” the researchers concluded. “While men’s CV risk improved in recent years, women’s risk worsened.”
Towfighi A. Arch Intern Med. 2009;169:1762-1766.