Environmental factors influence sex differences in coronary heart disease mortality

Sex differences in mortality from coronary heart disease are not determined primarily by endogenous oestrogen but are largely the result of environmental factors. On page 541 Lawlor et al present detailed analyses of trends in sex differences in coronary heart disease mortality over the past 80 years and show divergence over a short period after the second world war in England and Wales. The coronary heart disease epidemic of the past century occurred only in men, and sex differences varied geographically in several industrialised countries. The environmental factors associated with the disease have important implications for public health.

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Sex matters: secular and geographical trends in sex differences in coronary heart disease mortality

D A Lawlor, S Ebrahim, and G Davey Smith
BMJ 2001 323: 541-545. [Abstract] [Full Text] [PDF]