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Gender

Dr Chris Jones explains how gender relates to the facts and figures of cardiovascular disease.
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There are other non-modifiable risk factors of cardiovascular disease. For example, gender. It used to be thought that cardiovascular disease, particularly heart attacks, were a predominantly male disease. This is nonsense. If we, again, look at those figures for cardiovascular death in 2010, of those 180,000 people dying, 88,000 were men and 92,000 were women. Clearly, there is no gender bias. In which case, why have I just told you that gender is a risk factor for cardiovascular disease? Well, we need to look at the figures a little more closely. We need to take those figures on cardiovascular disease deaths and stratify them for age. In other words, we need to look who’s dying at what age.
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If we again look at those 180,000 people, but this time, only look at those dying below the age of 75, we find that 32,000 of these people were men. Whereas only 15,000 were women. So 68% of the people dying of cardiovascular disease below the age of 75 were men. Similarly, if we look at people dying below the age of 65, we can see that 15,000 of these were men and only 6,000 were women. So 72% were men. Clearly, whilst gender doesn’t affect your absolute risk of dying of cardiovascular disease, it does seem to affect the risk of dying at a younger age. Why this should be isn’t exactly clear. The diseases appear to be the same in men and women.
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And they’re driven by the same risk factors. And while there may be some element of lifestyle that’s playing into these figures - so the difference in gender lifestyles in the late 20th century in the UK, that doesn’t account for all of it. And there seems to be some fundamental reasons, as well. In the year 2000, Henry McGill and colleagues published a paper in a journal called Arteriosclerosis Thrombosis and Vascular Biology. This was a fascinating, if slightly macabre paper, in which they looked at 2,876 autopsies from young people. So people aged between 15 and 34 who died in accidents from murder or from suicide. But were otherwise healthy at their time of death.
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What they found was that even in the very youngest subjects, there was already the development of fatty streaks. So in subjects who were 15 to 19 years old, they already had fatty streaks. The progression of these fatty streaks into raised lesions increased with age. And they were appreciable levels of raised lesions in the 20 to 24-year-old groups. What’s more, the progression was different in men and women and depended on where the lesions were occurring. So clearly, gender does appear to have an influence on the progression of cardiovascular disease even at a young age.

In this video Dr Chris Jones from the School of Biological Sciences discusses gender as a non-modifiable risk factor for cardiovascular disease, and explains the difference between cause and correlation.

You can download the Week 4 supplement, which contains additional images and descriptions to help you understand the topics covered in this video.

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Heart Health: A Beginner's Guide to Cardiovascular Disease

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