Risk factors for coronary disease and stroke in men and women

We studied the influence of gender on the relations between cholesterol and coronary mortality, and between diastolic blood pressure and stroke mortality, Men (n=7137) and women (n=8262) aged 45-64 years from Renfrew and Paisley in the west of Scotland were first examined in 1972-76, and then followed for 17 years. Coronary and stroke mortality were calculated as deaths per thousand patient-years, and adjusted for the effects of competing risk factors. Plasma cholesterol was positively related to coronary mortality in both sexes. Absolute risk of coronary death was however, so much less in women that a woman with high cholesterol (> 7.2 mmol/l) was at lower risk than a man with low cholesterol (<5.0 mmol/l). Diastolic blood pressure was positively related to stroke mortality in both sexes, but here the absolute risks were similar in each Sex. Stroke mortality was highest in hypertensive men and women who smoked and had hyperlipidaemia. Although for primary prevention of stroke by treatment of hypertension, similar management could be used in men and women, primary prevention of coronary disease by lipid-lowering may well require different policies for the two sexes, corresponding to their different absolute risk and potential for benefit.