Coronary Risk in Women: Potential Role of Age, Lipoproteins, Haemostasis, and Hormones

In industrialized countries, cardiovascular diseases are the leading cause of death in both men and women. However, men mostly suffer from myocardial infarction (Ml) in the fifth and sixth decades of life, whereas during this period incidence of Ml is low in women but increases dramatically after age 55. The reason for these sex-specific differences in the development of coronary heart disease (CHD) is currently unknown but has mostly been adressed to the protective effect of estrogens in women because coronary risk increases severely after both physiological menopause and ovarectomy (reviewed in Bush et al. 1988, Corrao et al. 1990). However, to date the antiatherogenic mechanism of estrogens is poorly understood. To explore possible mechanisms, we analysed lipids, hemostatic, and endocrine parameters in female and male participants of the Prospective Cardiovascular Munster (PRO-CAM) study. The following questions were asked: 1)Which risk parameters change differently in men and women throughout age? 2) Are there sex-specific statistical interrelationships between these parameters? 3) Do non-sex hormones affect some risk parameters sex-specifically?