THE DEVELOPMENT OF SEX-DIFFERENCES IN CARDIOVASCULAR-DISEASE MORTALITY - A HISTORICAL-PERSPECTIVE

Objectives. Little is known about why males have higher cardiovascular disease (CVD) mortality rates than do females. An important factor th at has hampered efforts in this regard Is the lack of clarity about wh ether male excess mortality from CVD has existed throughout history. T o answer this question, an investigation was conducted of trends in CV D mortality differences between the sexes from the rime when data firs t became available until the present. including the full range of age groups. Methods. Mortality statistics for CVD in England and Wales fro m 1861 through 1992 and in the United States from 1900 through 1991 we re used. Results. Three stages in the relationship between male and fe male CVD mortality were found: (1) An early stage of equal male and fe male mortality (2) a stage of the appearance of sex differences in mor tality, and (3) a stage with consistently present male excess mortalit y. Conclusion. Male excess mortality from CVD has not always been pres ent in the historical record. Further research is needed to elucidate the causes of this excess mortality.