Sex-Related Disparities in Cardiovascular Outcomes - EMJ

Sex-Related Disparities in Cardiovascular Outcomes

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SEX-related disparities in cardiovascular outcomes have been found in older adults with late-onset hypertension. Previously, the relationship between sex and cardiovascular outcomes in older adults had not been explored; however, this new study, conducted by Ann Bugeja, University of Ottawa and The Ottawa Hospital, Ontario, Canada, and team, has demonstrated that there are indeed disparities between males and females.

The population-based study, based in Canada, involved 266,273 adults (aged ≥66 years; mean age: 74 years; 51% female; n=135,531) with newly diagnosed hypertension. The researchers aimed to determine the incidence of the primary composite cardiovascular outcome (myocardial infarction, stroke, and congestive heart failure), all-cause mortality, and cardiovascular death. The team utilised the Cox proportional hazard models adjusted for demographic factors and comorbidities.

Results demonstrated that, over a median follow-up of 6.6 (4.7–9.0) years, females experienced a lower crude incidence rate (per 1,000 person-years) than males for the primary composite cardiovascular outcome (287.3 versus 311.7), death (238.4 versus 251.4), and cardiovascular death (395.7 versus 439.6); P<0.001. They additionally found that the risk of primary composite cardiovascular outcome was significantly lower among females than in males (adjusted hazard ratio: 0.75; 95% confidence interval: 0.73–0.76; P<0.001). This was consistent after adjusting for the competing risk of all-cause death (95% confidence interval: 0.86–0.91; P<0.001).

Bugeja and colleagues concluded that older females with recently diagnosed hypertension had a lower risk of cardiovascular outcomes when compared to older males also with late-onset hypertension. The authors pointed out that their results highlight that the severity of outcomes is influenced by sex in relation to the age at which hypertension is diagnosed. However, they emphasise the need for further studies into the subject to identify sex-specific variations in the diagnosis and management of late-onset hypertension due to its high incidence in this group. ­­­



Bugeja et al. Sex-related disparities in cardiovascular outcomes among older adults with late-onset hypertension. Hypertension. 2024;DOI:10.1161/HYPERTENSIONAHA.124.22870.

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