SEX-DIFFERENCES IN SUSCEPTIBILITY TO ETIOLOGIC FACTORS FOR PERIPHERALATHEROSCLEROSIS - IMPORTANCE OF PLASMA-FIBRINOGEN AND BLOOD-VISCOSITY

Cardiovascular risk factors in men, such as cigarette smoking, hyperch olesterolemia, and hypertension, also increase risk in women, but the relative susceptibility to risk factors between the sexes is not estab lished. Our aim was to investigate a wide range of possible etiologic factors in a single population study and identify those that were more strongly related to peripheral atherosclerosis in men or women. We st udied personal factors (age and social class), lifestyle factors (smok ing, exercise, alcohol intake, and dietary nutrients), and intermediar y factors (obesity, diabetes, serum lipids, coagulation, and theologic al factors). In the Edinburgh Artery Study in 1988 we measured cardiov ascular risk factors in a random population sample of 1592 men and wom en aged 55 to 74 years. The ankle-brachial pressure index (ABPI), whic h is inversely related to the degree of peripheral atherosclerosis, wa s assessed in each subject. Lifetime cigarette smoking was correlated with a lower ABPI equally in men and women (r=-.27, P<.001). Dietary n utrients and alcohol intake were not related differently between the s exes with ABPI. However, recall of strenuous and moderate leisure time exercise during the age range of 35 to 45 years was related more stro ngly to a higher ABPI in men than in women (P<.05). Plasma fibrinogen, plasma viscosity, and blood viscosity were the only intermediary fact ors that had stronger univariate correlations with lower ABPI in men t han in women. On multivariate analysis, the sex differences persisted for plasma fibrinogen (P<.05) and blood viscosity (P<.001); high-densi ty lipoprotein cholesterol was related to ABPI in men only (sex differ ence, P<.1). We conclude that most lifestyle and intermediary factors were not related differently in men and women to peripheral atheroscle rosis, but elevations in plasma fibrinogen and blood viscosity were ea ch associated with a greater risk of disease in men.