RISK-FACTORS FOR CORONARY-DISEASE AND STROKE IN MEN AND WOMEN

We studied the influence of gender on the relations between cholestero l and coronary mortality, and between diastolic blood pressure and str oke mortality, Men (n=7137) and women (n=8262) aged 45-64 years from R enfrew and Paisley in the west of Scotland were first examined in 1972 -76, and then followed for 17 years. Coronary and stroke mortality wer e calculated as deaths per thousand patient-years, and adjusted for th e effects of competing risk factors. Plasma cholesterol was positively related to coronary mortality in both sexes. Absolute risk of coronar y death was however, so much less in women that a woman with high chol esterol (> 7.2 mmol/l) was at lower risk than a man with low cholester ol (<5.0 mmol/l). Diastolic blood pressure was positively related to s troke mortality in both sexes, but here the absolute risks were simila r in each Sex. Stroke mortality was highest in hypertensive men and wo men who smoked and had hyperlipidaemia. Although for primary preventio n 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, corre sponding to their different absolute risk and potential for benefit.