Sex related cardiovascular risk stratification based on quantification of atherosclerosis and inflammation

Atherosclerosis 197 (2008) 662–672

Raimund Erbel, Stefan Möhlenkamp, Nils Lehmannb, Axel Schmermund, Susanne Moebus, Andreas Stang, Dietrich Grönemeyer, Rainer Seibel, Klaus Manng, Lothar Volbracht, Nico Dragano, Johannes Siegrist, Karl-Heinz Jöckel, on behalf of the Heinz Nixdorf Recall Study Investigative Group

Background: The National Cholesterol Education Program in Adult Treatment Panel III (NCEP ATP III) suggests using CAC and hs-CRP in individuals at intermediate risk. The effect on risk stratification was not yet tested in the general population.

erbel_atherosclerosis-2008_Tab1Baseline data demonstrate substantial rates of obesity, hypertension, smoking, and hypercholesterolemia in the general population (Tables 1 and 2). Total cholesterol- and
HDL-levels were higher but triglyceride-levels and blood pressures lower in women. Triglyceride levels were higher in those who fasted <6 h compared to those that fasted
>6 h (159±95 mg/dL versus 141±100 mg/dL, p < 0.0001). BMI and hs-CRP-levels were similar in men and women (Tables 1 and 2). CAD participants had higher rates of known hypercholesterolemia but lower levels of total and LDL cholesterol. CAD participants also showed several-fold higher rates of known hypertension, past or active smoking, diabetes, stroke, and PAD compared to subjects without CAD. No male and only 5 (8.1%) of 62 female CAD participants had no CAC.

erbel_atherosclerosis-2008_Tab2The mean FRS was twice as high in men compared to women (Tables 1 and 2). However, one quarter of men but only 1.3% women without CAD were stratified into the high FRSgroup. Subjects withCADhad a higher FRS.Yet, despite a CAD history, almost 20% of men and more than 60% of women were categorized as being at low FRS. (weiter…)