Sex differences in prevalence and characteristics of imaging-detected atherosclerosis: a population-based study
Abstract Aims Men are more likely to suffer a myocardial infarction than women, but population-based studies on sex differences in imaging-detected atherosclerosis are lacking. The aims were to assess sex differences in the prevalence of imaging-detected coronary and carotid atherosclerosis, as well as multivariable adjusted associations between sex and atherosclerosis. Methods and results Participants aged 50–65, recruited from the general population to the Swedish Cardiopulmonary bioImage Study (SCAPIS), were included in this population-based cross-sectional study. Comprehensive diagnostics, including coronary computed tomography angiography and carotid ultrasound, were performed. The image findings were any coronary atherosclerosis, coronary stenosis ≥ 50%, segment involvement score (SIS) ≥ 4, coronary artery calcium score (CACS) > 100, and any ultrasound-detected carotid plaque. In 25 580 participants (50% women), men had more hypertension (20.3% vs. 17.0%), hyperlipidaemia (9.0% vs. 5.5%), and diabetes (8.5% vs. 4.7%). The prevalence was 56.2% vs. 29.5% for any coronary atherosclerosis (P < 0.01), 9.0% vs. 2.3% for coronary stenosis ≥ 50% (P < 0.01), 20.2% vs. 5.3% for SIS ≥ 4 (P < 0.01), 18.2% vs. 5.6% for CACS > 100 (P < 0.01), and 60.9% vs. 48.7% for carotid plaque (P < 0.01), in men vs. women, respectively. Multivariable adjustment only marginally changed these associations: odds ratios (ORs) (95% confidence interval): 2.75 (2.53–2.99) for coronary atherosclerosis, 2.88 (2.40–3.45) for coronary stenosis ≥ 50%, 3.99 (3.50–4.55) for SIS ≥ 4, 3.29 (2.88–3.75) for CACS > 100, and 1.57 (1.45–1.70) for carotid plaque. Conclusion Men had higher prevalence of imaging-detected carotid and coronary atherosclerosis with prevalence in women aged 65 corresponding to men 11–13 years younger. The associations remained after extensive multivariable adjustment.
Authors
- Linda Johnson (ORCID: https://orcid.org/0000-0002-2249-8220)
- Karin Leander (ORCID: https://orcid.org/0000-0002-1404-9222)
- Gunnar Engström (ORCID: https://orcid.org/0000-0002-8618-9152)
- Eva Swahn (ORCID: https://orcid.org/0000-0002-2608-2062)
- Mia Söderberg (ORCID: https://orcid.org/0000-0003-0662-6541)
- Ellen Ostenfeld (ORCID: https://orcid.org/0000-0002-2655-2423)
- Erika Fagman (ORCID: https://orcid.org/0000-0002-0983-0313)
- Joakim Alfredsson (ORCID: https://orcid.org/0000-0002-1415-7178)
- Tomas Jernberg (ORCID: https://orcid.org/0000-0003-1695-379X)
- Nina Johnston (ORCID: https://orcid.org/0000-0001-6560-169X)
- Annika Rosengren (ORCID: https://orcid.org/0000-0002-5409-6605)
- Sofia Sederholm Lawesson (ORCID: https://orcid.org/0000-0002-4776-0870)
- Carl Johan Östgren (ORCID: https://orcid.org/0000-0003-1617-3179)
- Johan Ljungberg (ORCID: https://orcid.org/0000-0002-3002-4877)
- Linn Skoglund Larsson (ORCID: https://orcid.org/0000-0001-8998-5691)
- Johan Sundström (ORCID: https://orcid.org/0000-0003-2247-8454)
- Oskar Angerås (ORCID: https://orcid.org/0000-0002-3474-2438)
- Elmir Ömerovic (ORCID: https://orcid.org/0000-0002-3875-8621)
- Jonas Oldgren (ORCID: https://orcid.org/0000-0002-9969-3921)
- Margaretha Persson (ORCID: https://orcid.org/0000-0001-8188-5792)
- Bengt Johansson (ORCID: https://orcid.org/0000-0003-0976-6910)
- Olov Duvernoy
- Maria J. Eriksson (ORCID: https://orcid.org/0000-0003-0784-7514)
- Maria Mannila (ORCID: https://orcid.org/0000-0001-6189-2901)
- Mats Fredrikson
- Maria Nordendahl
Institutions
- Linköping University (SE)
- Uppsala University (SE)
- National Academy of Medicine (US)
- Karolinska University Hospital (SE)
- Malmö University (SE)
- Lund University (SE)
- Sahlgrenska University Hospital (SE)
- Karolinska Institutet (SE)
- UNSW Sydney (AU)
- The George Institute for Global Health (AU)
- Skåne University Hospital (SE)
- University of Gothenburg (SE)
- Umeå University (SE)
Publication Details
- Journal
- European Heart Journal - Cardiovascular Imaging
- Published
- 2024-08-19
- DOI
- https://doi.org/10.1093/ehjci/jeae217
- Citations
- 17
- Primary Topic
- Cardiac Imaging and Diagnostics
- Type
- article
- Field-Weighted Citation Impact
- 6.87
Funders
- University Hospitals
- AFA Försäkring
- Lunds Universitet
- Svenska Sällskapet för Medicinsk Forskning
- Hjärt-Lungfonden
- Linköpings Universitet
- Karolinska Institutet
- Knut och Alice Wallenbergs Stiftelse
- Stockholms Läns Landsting
- Vetenskapsrådet
- Umeå Universitet
- Sahlgrenska Universitetssjukhuset
- Göteborgs Universitet
- Uppsala Universitet
- Skånes universitetssjukhus