Coronary heart disease in womenBMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6964.1303a (Published 12 November 1994) Cite this as: BMJ 1994;309:1303
- H Tunstall-Pedoe,
- C Morrison
Women may be more ill when they reach hospital
EDITOR, - Three papers in the issue of 3 September follow the recent publication of findings in 38 populations worldwide from the World Health Organisation's MONICA project (to monitor the trends in and determinants of cardiovascular diseases).4 Our comparison from the Scottish MONICA project in Glasgow from 1985 to 1991 of 3991 myocardial infarctions and coronary deaths in men with 1551 in women (aged 25-64) gives an added perspective.
The international study (which used standardised criteria monitored from Dundee) shows a negative correlation in women, but not men, between population event rates and case fatality at 28 days. Case fatality among women is highest where coronary disease is uncommon, and non-fatal cases in women may be being missed, but is similar to that among men where coronary event rates are high.4 However, this report (besides incidentally redefining the alleged French paradox5,6 as common to southern Europe) also shows a difference between the sexes in how suddenly and where deaths occur, …