Influence of High-Density Lipoprotein Cholesterol and Rheological Factors on the Sex Difference in Cardiovascular Disease

BackgroundIt is well established that the incidence of cardiovascular disease among men is higher than that among women.ObjectiveTo determine whether differences between men and women in terms of a range of conventional and rheological risk factors could explain this sex difference.DesignThis was a population-based cohort study (the Edinburgh Artery Study).MethodsMen and women aged 55–74 years (n = 1592) were selected at random from the general population of Edinburgh and followed up for 5 years. Baseline cardiovascular risk factors were measured and related to incidence of disease among men and women.ResultsMen had higher levels of cigarette smoking, haematocrit and blood viscosity and lower levels of low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol and plasma fibrinogen than did women. The incidences of cardiovascular events among men and women were 48.3 and 26.1 per 1000 person-years, respectively. Adjustment for level of HDL cholesterol reduced the male: female rat...