Intended for healthcare professionals


Sex differences in the risk of cardiovascular disease

BMJ 2011; 343 doi: (Published 06 September 2011) Cite this as: BMJ 2011;343:d5526
  1. Nisha I Parikh, assistant professor of medicine
  1. 1John A Burns School of Medicine, University of Hawaii and Division of Cardiology, Queen’s Medical Center, Honolulu HI 96813, USA
  1. nparikh{at}

The accelerated risk at menopause may not be as clear as previously thought

Long before the landmark Women’s Health Initiative clinical trial studied the effects of hormone replacement therapy (HRT) on cardiovascular disease in postmenopausal women, several questions framed the debate about whether menopause truly represented a period of equalisation between women and men in the risk of cardiovascular disease.1 2 Was menopause a pathophysiological turning point for women, or was the acceleration in risk due to natural ageing processes, independent of the hormonal effects of menopause? Recent studies have asked whether cardiovascular disease risk factors lead to menopause rather than the other way around.3 Still, the overarching question remains: if a sex gap exists in the risk of cardiovascular disease, how can we use our understanding of what drives this difference to take better care of our patients and ultimately to close the divide?

The linked study by Vaidya and colleagues (doi:10.1136/bmj.d5170) substantially extends our understanding of the epidemiology of sex differences in death from ischaemic …

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