The Effect of Cardiovascular Comorbidities on Women Compared to Men: Longitudinal Retrospective Analysis

Elma Dervic; Carola Deischinger; Nils Haug; Michael Leutner; Alexandra Kautzky-Willer; Peter Klimek

doi:10.2196/28015

The Effect of Cardiovascular Comorbidities on Women Compared to Men: Longitudinal Retrospective Analysis

JMIR Cardio. 2021 Oct 4;5(2):e28015. doi: 10.2196/28015.

Authors

Elma Dervic^#^{1

2}, Carola Deischinger^#³, Nils Haug^{1

2}, Michael Leutner³, Alexandra Kautzky-Willer^{3

4}, Peter Klimek^{1

2}

Affiliations

¹ Section for Science of Complex Systems, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
² Complexity Science Hub Vienna, Vienna, Austria.
³ Department of Internal Medicine III, Clinical Division of Endocrinology and Metabolism, Gender Medicine Unit, Medical University of Vienna, Vienna, Austria.
⁴ Gender Institute, Gars am Kamp, Austria.

^# Contributed equally.

PMID: 34605767
PMCID: PMC8723790
DOI: 10.2196/28015

Abstract

Background: Although men are more prone to developing cardiovascular disease (CVD) than women, risk factors for CVD, such as nicotine abuse and diabetes mellitus, have been shown to be more detrimental in women than in men.

Objective: We developed a method to systematically investigate population-wide electronic health records for all possible associations between risk factors for CVD and other diagnoses. The developed structured approach allows an exploratory and comprehensive screening of all possible comorbidities of CVD, which are more connected to CVD in either men or women.

Methods: Based on a population-wide medical claims dataset comprising 44 million records of inpatient stays in Austria from 2003 to 2014, we determined comorbidities of acute myocardial infarction (AMI; International Classification of Diseases, Tenth Revision [ICD-10] code I21) and chronic ischemic heart disease (CHD; ICD-10 code I25) with a significantly different prevalence in men and women. We introduced a measure of sex difference as a measure of differences in logarithmic odds ratios (ORs) between male and female patients in units of pooled standard errors.

Results: Except for lipid metabolism disorders (OR for females [ORf]=6.68, 95% confidence interval [CI]=6.57-6.79, OR for males [ORm]=8.31, 95% CI=8.21-8.41), all identified comorbidities were more likely to be associated with AMI and CHD in females than in males: nicotine dependence (ORf=6.16, 95% CI=5.96-6.36, ORm=4.43, 95% CI=4.35-4.5), diabetes mellitus (ORf=3.52, 95% CI=3.45-3.59, ORm=3.13, 95% CI=3.07-3.19), obesity (ORf=3.64, 95% CI=3.56-3.72, ORm=3.33, 95% CI=3.27-3.39), renal disorders (ORf=4.27, 95% CI=4.11-4.44, ORm=3.74, 95% CI=3.67-3.81), asthma (ORf=2.09, 95% CI=1.96-2.23, ORm=1.59, 95% CI=1.5-1.68), and COPD (ORf=2.09, 95% CI 1.96-2.23, ORm=1.59, 95% CI 1.5-1.68). Similar results could be observed for AMI.

Conclusions: Although AMI and CHD are more prevalent in men, women appear to be more affected by certain comorbidities of AMI and CHD in their risk for developing CVD.

Keywords: acute myocardial infarction; cardiovascular diseases; chronic ischemic heart disease; comorbidities; diabetes; gender; gender gap; risk factors; sex differences; smoking.

©Elma Dervic, Carola Deischinger, Nils Haug, Michael Leutner, Alexandra Kautzky-Willer, Peter Klimek. Originally published in JMIR Cardio (https://cardio.jmir.org), 04.10.2021.