Abstract
OBJECTIVES: Little is known about why males have higher cardiovascular disease (CVD) mortality rates than do females. An important factor that has hampered efforts in this regard is the lack of clarity about whether male excess mortality from CVD has existed throughout history. To answer this question, an investigation was conducted of trends in CVD mortality differences between the sexes from the time when data first became available until the present, including the full range of age groups. METHODS: Mortality statistics for CVD in England and Wales from 1861 through 1992 and in the United States from 1900 through 1991 were used. RESULTS: Three stages in the relationship between male and female CVD mortality were found: (1) An early stage of equal male and female mortality, (2) a stage of the appearance of sex differences in mortality, and (3) a stage with consistently present male excess mortality. CONCLUSION: Male excess mortality from CVD has not always been present in the historical record. Further research is needed to elucidate the causes of this excess mortality.
Full text
PDF





Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Anderson T. W. The changing pattern of ischemic heart disease. Can Med Assoc J. 1973 Jun 23;108(12):1500–1504. [PMC free article] [PubMed] [Google Scholar]
- Davies J. W., Semenciw R. M., Mao Y. Cardiovascular disease mortality trends and related risk factors in Canada. Can J Cardiol. 1988 Jul;4 (Suppl A):16A–20A. [PubMed] [Google Scholar]
- ENTERLINE P. E. Causes of death responsible for recent increases in sex mortality differentials in the United States. Milbank Mem Fund Q. 1961 Apr;39:312–328. [PubMed] [Google Scholar]
- Halliday M. L., Anderson T. W. The sex differential in ischaemic heart disease: trends by social class 1931 to 1971. J Epidemiol Community Health. 1979 Mar;33(1):74–77. doi: 10.1136/jech.33.1.74. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hammond E. C. Smoking in relation to the death rates of one million men and women. Natl Cancer Inst Monogr. 1966 Jan;19:127–204. [PubMed] [Google Scholar]
- Hazzard W. R. Biological basis of the sex differential in longevity. J Am Geriatr Soc. 1986 Jun;34(6):455–471. doi: 10.1111/j.1532-5415.1986.tb03414.x. [DOI] [PubMed] [Google Scholar]
- Johansson S. Longevity in women. Cardiovasc Clin. 1989;19(3):3–16. [PubMed] [Google Scholar]
- Johnson A. Sex differentials in coronary heart disease: the explanatory role of primary risk factors. J Health Soc Behav. 1978 Mar;18(1):46–54. [PubMed] [Google Scholar]
- Luepker R. V., Jacobs D. R., Gillum R. F., Folsom A. R., Prineas R. J., Blackburn H. Population risk of cardiovascular disease: the Minnesota Heart Survey. J Chronic Dis. 1985;38(8):671–682. doi: 10.1016/0021-9681(85)90021-9. [DOI] [PubMed] [Google Scholar]
- MADIGAN F. C. Are sex mortality differentials biologically caused? Milbank Mem Fund Q. 1957 Apr;35(2):202–223. [PubMed] [Google Scholar]
- MORIYAMA I. M., WOOLSEY T. D., STAMLER J. Observations on possible factors responsible for the sex and race trends in cardiovascular-renal mortality in the United States. J Chronic Dis. 1958 May;7(5):401–412. doi: 10.1016/0021-9681(58)90104-8. [DOI] [PubMed] [Google Scholar]
- Qvist J., Johansson S. E., Johansson L. M. Multivariate analyses of mortality from coronary heart disease due to biological and behavioural factors. Scand J Soc Med. 1996 Mar;24(1):67–76. doi: 10.1177/140349489602400111. [DOI] [PubMed] [Google Scholar]
- Retherford R. D. Tobacco smoking and the sex mortality differential. Demography. 1972 May;9(2):203–216. [PubMed] [Google Scholar]
- Stamler J. The marked decline in coronary heart disease mortality rates in the United States, 1968-1981; summary of findings and possible explanations. Cardiology. 1985;72(1-2):11–22. doi: 10.1159/000173836. [DOI] [PubMed] [Google Scholar]
- Uemura K., Pisa Z. Trends in cardiovascular disease mortality in industrialized countries since 1950. World Health Stat Q. 1988;41(3-4):155–178. [PubMed] [Google Scholar]
- Waldron I., Johnston S. Why do women live longer than men? J Human Stress. 1976 Jun;2(2):19–30. doi: 10.1080/0097840X.1976.9936063. [DOI] [PubMed] [Google Scholar]
- Waldron I. Recent trends in sex mortality ratios for adults in developed countries. Soc Sci Med. 1993 Feb;36(4):451–462. doi: 10.1016/0277-9536(93)90407-u. [DOI] [PubMed] [Google Scholar]
- Wingard D. L. The sex differential in mortality rates: demographic and behavioral factors. Am J Epidemiol. 1982 Feb;115(2):205–216. doi: 10.1093/oxfordjournals.aje.a113292. [DOI] [PubMed] [Google Scholar]