Abstract P347: Risk of Incident Coronary Heart Disease Events in Men Compared to Women by Menopause Type and Race

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Catherine Kim ◽  
Mary Cushman ◽  
Yulia Khodneva ◽  
Lynda D Lisabeth ◽  
Suzanne Judd ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Sex Differences ◽  
Heart Disease ◽  
Lower Risk ◽  
Natural Menopause ◽  
Chd Risk ◽  
Surgical Menopause ◽  
Chd Risk Factors ◽  
The Impact

Introduction: Men have greater risk of coronary heart disease (CHD) compared to women. It is unclear whether type of menopause affects this sex difference and if the impact is similar in blacks and whites. Moreover, women and their physicians may consider CHD risk when considering whether elective hysterectomy and/or bilateral salpingo-oophorectomy (BSO) are performed. Hypotheses: Women who undergo natural menopause, menopause due to BSO, and menopause due to hysterectomy alone have different risks of non-fatal CHD and acute CHD death compared to men. Methods: Participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort between 2003 and 2007 without CHD at baseline (n=23,086), with follow-up through December 2011. Cox proportional hazard models were used to calculate the hazard of incident CHD events in men vs. women by menopause type, stratified by black vs. white race. The main outcome measure was adjudicated incident CHD events, defined as nonfatal CHD (definite or probably myocardial infarction) and acute CHD death. Results: Over a median 6.0 years of follow-up, 892 incident CHD events occurred. Cox regression models adjusted for age, age at last menstrual period < 45 years, region, education level, income, CHD risk factors (total cholesterol, high-density lipoprotein, smoking, systolic blood pressure, diabetes, albumin to creatinine ratio, physical activity, C-reactive protein, body mass index and waist circumference), and use of anti-hypertensive medications, statins, and estrogen therapy. Associations of menopause with non-fatal events differed by race (p for interaction=0.03). Among white women, natural menopause (hazard ratio [HR] 0.45, 95% CI 0.31, 0.66) and surgical menopause (HR 0.65, 95% CI 0.42, 0.99) were associated with a reduced hazard of non-fatal events compared to white men. Among black women, natural menopause was marginally significantly associated with lower hazard of non-fatal events compared to men (HR 0.69, 95% CI 0.47, 1.03) but surgical menopause was not (HR 0.81, 95% CI 0.51, 1.29). For acute CHD death, women had lower risk than men regardless of their menopause type and race. Conclusions and Relevance: Sex differences in the risk of incident CHD events were larger among whites than blacks and varied by type of menopause. Women consistently had a lower risk of incident CHD death than men, but the magnitude of sex differences was greater in whites than blacks for non-fatal events regardless of menopause type. Menopause type was not associated with large differences in the hazard for CHD risk.

Abstract P370: Obesity and Incident Coronary Heart Disease in the Million Women Study: A Prospective, Population-based Cohort Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Dexter Canoy ◽  
Benjamin J Cairns ◽  
Angela Balkwill ◽  
Jayne Green ◽  
Lucy Wright ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cumulative Risk ◽  
Excess Weight ◽  
Adjusted Relative Risk ◽  
Chd Risk ◽  
Wide Range ◽  
Chd Risk Factors ◽  
The Impact

Background: Higher body-mass index (BMI) has been associated with increased risk for coronary heart disease (CHD) mortality but its association with incident CHD is less investigated, and data for women are limited. Methods: We examined the prospective relation between BMI and incident CHD (first CHD hospitalization or death) in 1.2 million women aged ≥50 years without prior CHD, who were recruited through a national breast screening programme in 1996 to 2001 and followed for an average of 9 years (48,842 events with 10.7 million person-years of follow-up). Absolute and relative risks (using Cox regression) associated with higher BMI were estimated. Results: After excluding the first 4 years of follow-up, there were 32,465 events (5.9 million person-years) including 3,345 CHD deaths. The adjusted relative risk per 5 kg/m 2 BMI difference was 1.24 [95% confidence interval (CI) 1.22 to 1.25]. CHD risk increased linearly across a wide range of BMI, with no apparent excess risk in the lower end of BMI distribution. The relation persisted after excluding current smokers or limiting cases to myocardial infarction only. For women in this cohort, the 20-year cumulative risk of CHD from age 55 to 74 years (95% CI) ranged from 9% (8 to10) to 18% (16 to 20) for women with BMI of 20 to 22.5 kg/m 2 and ≥35 kg/m 2 , respectively. Never smokers with BMI ≥35 kg/m 2 had comparable cumulative risk to current smokers with BMI of 20 to 22.5 kg/m 2 . Conclusion: In this large cohort of women, the impact of excess weight on CHD morbidity and mortality is substantial. Measures to prevent and control excess weight and other CHD risk factors are needed to help reduce CHD burden in women.

scholarly journals The Impact of Risk Factors for Coronary Heart Disease on Related Disability in Older Irish Adults

2017 ◽  
Vol 31 (1) ◽  
pp. 165-184 ◽  
Author(s):  
Sharon M. Cruise ◽  
John Hughes ◽  
Kathleen Bennett ◽  
Anne Kouvonen ◽  
Frank Kee
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Northern Ireland ◽  
Physical Inactivity ◽  
Relative Risks ◽  
Chd Risk ◽  
Health And Social Care ◽  
Chd Risk Factors ◽  
The Impact

Objective: The aim of this study is to examine the prevalence of coronary heart disease (CHD)–related disability (hereafter also “disability”) and the impact of CHD risk factors on disability in older adults in the Republic of Ireland (ROI) and Northern Ireland (NI). Method: Population attributable fractions were calculated using risk factor relative risks and disability prevalence derived from The Irish Longitudinal Study on Ageing and the Northern Ireland Health Survey. Results: Disability was significantly lower in ROI (4.1% vs. 8.8%). Smoking and diabetes prevalence rates, and the fraction of disability that could be attributed to smoking (ROI: 6.6%; NI: 6.1%), obesity (ROI: 13.8%; NI: 11.3%), and diabetes (ROI: 6.2%; NI: 7.2%), were comparable in both countries. Physical inactivity (31.3% vs. 54.8%) and depression (10.2% vs. 17.6%) were lower in ROI. Disability attributable to depression (ROI: 16.3%; NI: 25.2%) and physical inactivity (ROI: 27.5%; NI: 39.9%) was lower in ROI. Discussion: Country-specific similarities and differences in the prevalence of disability and associated risk factors will inform public health and social care policy in both countries.

Abstract P001: Dietary and Plasma Magnesium and Risk of Coronary Heart Disease among Women

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Stephanie E Chiuve ◽  
Kathryn M Rexrode ◽  
Qi Sun ◽  
Eric N Taylor ◽  
Gary C Curhan ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Lower Risk ◽  
Threshold Effect ◽  
Health Study ◽  
Control Analysis ◽  
Inverse Association ◽  
Chd Risk ◽  
Plasma Magnesium ◽  
Chd Risk Factors

Background: Plasma magnesium (Mg) has been strongly associated with lower risk of fatal coronary heart disease (CHD) and sudden cardiac death, which may be due to its anti-arrhythmic properties. Mg also affects endothelial function, inflammation, blood pressure and diabetes and thus may impact atherosclerosis in general. We examined the association between magnesium, measured in diet and plasma, and risk of fatal, nonfatal and total CHD among women in the Nurses’ Health Study. Design: The association for Mg intake was examined prospectively among 86,361 women free of disease in 1980. Mg intake and other covariates were ascertained updated every 2-4 years through questionnaires and 3661 cases of CHD (1214 fatal/2447 nonfatal) were documented through 2008. For plasma Mg, we conducted a nested case-control analysis with 405 CHD (63 fatal/342 nonfatal) cases, matched to controls (1:1) on age, smoking, fasting status, and date of blood sampling. Results: Dietary magnesium was inversely associated with risk of CHD, even after controlling for diet and CHD risk factors (RR comparing extreme quintiles: 0.75; 95%CI: 0.64, 0.89; P trend=0.002) (Table 1). The relationship with plasma Mg was less linear ( P trend=0.09) with a potential threshold effect at the 2 nd quintile. The RR of CHD comparing plasma Mg >2.0 v. ≤2.0 mg/dl was 0.49 (95%CI: 0.32, 0.74). The associations for dietary and plasma Mg appeared stronger for fatal versus nonfatal CHD. The RR (95%CI; P trend) comparing the highest to lowest quintile of dietary Mg was 0.60 (0.45, 0.79; p <0.001) for fatal and 0.85 (0.70, 1.04; p = 0.14) for nonfatal CHD. The RR (95%CI) comparing plasma Mg >2.0 v. ≤2.0 mg/dl was 0.23 (0.07, 0.81) for fatal and 0.55 (0.35, 0.86) for nonfatal CHD. Conclusions: Higher levels of Mg, in diet and plasma, were associated with lower risk of total CHD among women. The consistent inverse association found between two measures of Mg and CHD risk supports the hypothesis that Mg might lower CHD risk through multiple mechanisms, and may be most strongly protective for fatal events.

scholarly journals Explaining the increment in coronary heart disease mortality in Mexico between 2000 and 2012

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242930
Author(s):  
Carmen Arroyo-Quiroz ◽  
Martin O’Flaherty ◽  
Maria Guzman-Castillo ◽  
Simon Capewell ◽  
Eduardo Chuquiure-Valenzuela ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Heart Disease Mortality ◽  
Population Level ◽  
Impact Model ◽  
Chd Risk ◽  
Chd Risk Factors ◽  
Surgical Treatments ◽  
The Impact

Background Mexico is still in the growing phase of the epidemic of coronary heart disease (CHD), with mortality increasing by 48% since 1980. However, no studies have analyzed the drivers of these trends. We aimed to model CHD deaths between 2000 and 2012 in Mexico and to quantify the proportion of the mortality change attributable to advances in medical treatments and to changes in population-wide cardiovascular risk factors. Methods We performed a retrospective analysis using the previously validated IMPACT model to explain observed changes in CHD mortality in Mexican adults. The model integrates nationwide data at two-time points (2000 and 2012) to quantify the effects on CHD mortality attributable to changes in risk factors and therapeutic trends. Results From 2000 to 2012, CHD mortality rates increased by 33.8% in men and by 22.8% in women. The IMPACT model explained 71% of the CHD mortality increase. Most of the mortality increases could be attributed to increases in population risk factors, such as diabetes (43%), physical inactivity (28%) and total cholesterol (24%). Improvements in medical and surgical treatments together prevented or postponed 40.3% of deaths; 10% was attributable to improvements in secondary prevention treatments following MI, while 5.3% to community heart failure treatments. Conclusions CHD mortality in Mexico is increasing due to adverse trends in major risk factors and suboptimal use of CHD treatments. Population-level interventions to reduce CHD risk factors are urgently needed, along with increased access and equitable distribution of therapies.

Abstract P041: Serum Magnesium and the Incidence of Coronary Heart Disease Over 20 Years of Follow-up: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Mary R Rooney ◽  
Jeffrey R Misialek ◽  
Alvaro Alonso ◽  
Aaron R Folsom ◽  
Erin D Michos ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Proportional Hazards ◽  
Serum Magnesium ◽  
A Priori ◽  
Cox Proportional Hazards ◽  
Chd Risk ◽  
Chd Risk Factors ◽  
Aric Study

Introduction: Low serum magnesium (Mg) levels have been associated with increased coronary heart disease (CHD) risk, likely acting through pathways such as hypertension, hyperglycemia or inflammation. An early (1998) ARIC paper evaluated this association, based on 319 events, and identified a sex-interaction whereby the inverse Mg-CHD association was stronger among women than men. Nearly 2,000 events have occurred since the prior publication. Hence, we sought to update the analysis. Hypothesis: We hypothesized serum Mg would be inversely and independently associated with long-term risk of CHD. Methods: A total of 14,465 ARIC study participants without CHD at visit 1 (baseline) were included. Serum Mg was measured at visit 1 (1987-89) and visit 2 (1990-92). Incident CHD events were identified through 2014 using annual telephone calls, hospital discharge lists and death certificates, and were adjudicated by physician review. Multivariable Cox proportional hazards regression models were used. Serum Mg was categorized into quintiles based on mean visit 1 and 2 concentrations. Based on prior findings in ARIC suggesting an interaction, we decided a priori to provide sex-stratified results. Results: Participants at baseline were mean±SD age 54±6y, 57% were women and 27% black. Serum Mg was 1.62±0.14 mEq/L overall, 1.62±0.14 mEq/L among women and 1.63±0.14 mEq/L among men. Over a median follow-up of 25 years, 1,939 CHD cases were identified. Overall, serum Mg was inversely and monotonically associated with CHD risk after adjustment for demographics, lifestyle factors and other CHD risk factors (Table, p-trend<0.001). The association was stronger among women (HR Q5 vs Q1=0.63) than men (HR=0.83), but the sex-interaction was not statistically significant (p>0.05). Conclusions: In this large community-based cohort, serum Mg was inversely associated with CHD risk. This association was slightly stronger among women than men. Further research is needed to understand if increasing Mg levels is a useful target for CHD prevention.

scholarly journals Reduction of cardiovascular risk in patients with metabolic syndrome in a community health center after a pharmaceutical care program of pharmacotherapy follow-up

2012 ◽  
Vol 48 (3) ◽  
pp. 435-446 ◽  
Author(s):  
Camila Pedro Plaster ◽  
Danilo Travassos Melo ◽  
Veraci Boldt ◽  
Karla Oliveira dos Santos Cassaro ◽  
Fernanda Campos Rosetti Lessa ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Health System ◽  
Pharmaceutical Care ◽  
Control Group ◽  
Chd Risk ◽  
The Impact

The objective of this study was to determine the impact of a pharmaceutical care (PC) program in a sample of public outpatients with metabolic syndrome (MS) who were being treated in Brazil's health system; the patients were randomized into PC or standard care. The pharmacotherapy follow-up (PF) was performed in a total of 120 patients with type 2 diabetes for 6 months. Adherence to treatment (measured with the Morisky test), negative outcomes associated with medication (NOM) and anthropometric and biochemical parameters were measured before and after PF. The Framingham scoring method was used to estimate changes in 10-year coronary heart disease risk scores in all patients. Ninety-six of 120 patients had characteristics of MS and were randomized into two groups (G): the control group (CG: 36) and the intervention group (IG: 38). Among the MS patients, 100% were taking a glucose-lowering drug; many were also taking anti-hypertensive drugs (CG: 72%; IG: 73%), and some patients were also taking hypolipemic drugs (CG: 12.0%; IG: 14.7%). Only 20.7% of the IG patients were considered adherent to their prescribed drugs. In the CG, an increase of coronary heart disease (CHD) risk (22±2 to 26±3; p<0.05) was observed, while in the IG, there was a reduction in CHD risk (22±2 to 14±2%; p<0.01). The PC program administered to patients with MS monitored through the primary healthcare services of the Brazilian public health system improved patient health, resulting in clinical improvements and a decrease in cardiovascular risk in IG patients over a period of ten years.

Abstract 045: Race-Sex Differences in Risk for Incident Acute Coronary Heart Disease in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Monika M Safford ◽  
Paul Muntner ◽  
Christopher Gamboa ◽  
Ronald Prineas ◽  
Todd Brown ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Sex Differences ◽  
Heart Disease ◽  
Black Men ◽  
Racial Differences ◽  
White Men ◽  
Men And Women ◽  
Chd Risk ◽  
Chd Risk Factors

National death certificate data suggest that racial disparities in acute coronary heart disease (CHD) mortality widened over the past decade for both men and women. To better understand this disparity, we examined black:white race-sex differences in overall, fatal and nonfatal acute CHD incidence in a large national biracial cohort. REGARDS is following 30,239 community-dwellers age ≥;45 years recruited between 2003-7 from 48 states. Recruitment was designed to balance race and sex; the final sample was 55% female and 41% black. Participants are telephoned every 6 months for CVD endpoints, with retrieval of medical records, death certificates, interviews with next-of-kin, and expert adjudication following national consensus recommendations. Acute CHD was defined as definite or probable myocardial infarction (MI) or acute CHD death. Among participants free of CHD at baseline, we examined black:white hazards for incident overall acute CHD, and, separately, fatal and nonfatal acute CHD for men and women through 2008, adjusting incrementally for sampling, sociodemographics and CHD risk factors. The study sample numbered 24,431 with mean age 64.1 (SD±9.3). Over a mean follow-up of 3.4 (maximum 5.9) years, 48.7% (55/113) of black men, 33.0% (38/115) of black women, 23.0% (46/200) of white men and 24.1% (21/87) of white women died at their presentation of acute CHD. Black:white hazard ratios for overall, fatal and nonfatal acute CHD from incrementally adjusted models stratified on sex are presented in the Table. Black men and women had over twice the age-adjusted hazard of incident fatal acute CHD compared to whites, not entirely explained by excess risk factor burden among blacks. Although socio-economic and CHD risk factors among blacks continue to be major contributors to fatal incident acute CHD, known risk factors did not fully explain the disparity between black and white men; causes of the elevated risk among black men need to be better understood if widening CHD mortality disparities are to be reversed.

scholarly journals Established risk factors for coronary heart disease are unrelated to androgen-induced baldness in female-to-male transsexuals

2004 ◽  
Vol 180 (1) ◽  
pp. 107-112 ◽  
Author(s):  
EJ Giltay ◽  
AW Toorians ◽  
AR Sarabdjitsingh ◽  
NA de Vries ◽  
LJ Gooren
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Hair Loss ◽  
Type I ◽  
Testosterone Undecanoate ◽  
Glucose Levels ◽  
Chd Risk ◽  
Chd Risk Factors

A high scalp sensitivity to androgens is part of the pathophysiology of male-pattern baldness (MPB). Androgens affect established risk factors for coronary heart disease (CHD), and a supposedly heightened impact on these risk factors is hypothesized to explain the epidemiological association between MPB and CHD. In this retrospective, observational study we studied 81 female-to-male transsexual (F-->M) subjects, mean age 36.7 years (range 21-61), treated with testosterone esters (n=61; 250 mg i.m./2 weeks) or testosterone undecanoate (n=20; 160-240 mg/day orally). The degree of MPB was self-assessed using a 5-point scale (i.e. type I (no hair loss) to type V (complete hair loss)). Body mass index, blood pressure and levels of lipid and insulin were retrospectively assessed at the start of testosterone administration (0.5-24 years before) and between 3 and 4 months of follow-up. We found that 31 of 81 (38.3%) F-->M transsexuals had MPB type II-V. Thinning of hair was related to the duration of androgen administration and present in about 50% of F-->M transsexuals after 13 years. None of the CHD risk factors at follow-up, nor proportional changes, was associated with the degree MPB, except that there was an unexpected tendency of lower fasting glucose levels in balding subjects. Therefore, our findings do not support the idea that MPB serves as an indicator of increased CHD risk through androgenic effects on classic CHD risk factors.

Abstract 001: Quantity and Variety in Fruit and Vegetable Intake and Risk of Coronary Heart Disease

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Shilpa N Bhupathiraju ◽  
Nicole M Wedick ◽  
An Pan ◽  
JoAnn E Manson ◽  
Kathryn M Rexrode ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Lower Risk ◽  
Fruit Juice ◽  
Vegetable Intake ◽  
Fruit And Vegetable Intake ◽  
Fruit And Vegetable ◽  
Markers Of Inflammation ◽  
Chd Risk

Epidemiological data have consistently documented a protective effect of fruit and vegetable intake on risk of coronary heart disease (CHD). Consequently, dietary guidelines recommend increasing fruit and vegetable intake and, most recently, have also suggested increasing variety. Our objective was to examine the independent roles of quantity and variety in fruit and vegetable intake in relation to incident CHD. We prospectively observed 71,157 women from the Nurses’ Health Study (NHS, 1984-2008) and 39,752 men from the Health Professionals Follow-up Study (HPFS, 1986-2008) who were free of diabetes, cardiovascular diseases, and cancer at baseline. We documented 2585 incident CHD cases in women during 24 years of follow-up and 3408 cases in men during 22 years of follow-up. Diet was assessed using a standardized and validated questionnaire and updated every 4 years. Variety was defined as the number of unique fruits and vegetables consumed at least once per week. To account for minor differences in the number of fruit and vegetable items administered at each follow-up cycle, we standardized our variety score to 30 (11 for fruit score and 19 for vegetable score). Potatoes, soy, or other legumes were not included in our analyses. Because the AHA does not consider fruit juice to be equivalent to whole fruit, fruit juice was also not included in our analyses. Quantity (servings/day) and variety in fruit and vegetable intake were correlated (r=0.68, P<0.0001). We, therefore, regressed variety on quantity to assess their independent effects on CHD risk. In multivariable analyses, after adjusting for dietary and non-dietary covariates, those in the highest fifth of fruit and vegetable intake (median intake=7.80 servings/day) had a 13% lower risk (95% CI, 0.79 to 0.95) of CHD compared to those in the lowest fifth (median intake=2.14 servings/day). Conversely, quantity-adjusted variety was not associated with CHD risk (RR for highest fifth compared to lowest fifth=1.04, 95% CI, 0.92 to 1.19). Further, within each category of quantity, higher variety was not associated with CHD risk. Our data suggest that absolute quantity, rather than variety, in fruit and vegetable intake is associated with a significantly lower risk of CHD. Future work should examine the role of variety in reducing biological markers of inflammation and endothelial dysfunction. Meanwhile, policy efforts should continue to focus on increasing overall fruit and vegetable intake.

Abstract P316: Prehypertension and Incident Acute Coronary Heart Disease in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Stephen P Glasser ◽  
Yulia Khodneva ◽  
Daniel Lackland ◽  
Ronald Prineas ◽  
Monika Safford
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Racial Differences ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Cox Proportional Hazards Models ◽  
Chd Risk ◽  
Regards Study ◽  
Chd Risk Factors

Objective: The independent prognostic value of prehypertension (preHTN) for incident coronary heart disease (CHD) remains unsettled. Using the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study, we examined associations between preHTN and incident acute CHD and CVD death. Methods: REGARDS includes 30,239 black and white community-dwelling adults age 45 and older at baseline. Recruitment occurred from 2003-7, with baseline interviews and in-home data collection for physiologic measures. Follow-up is conducted by telephone every 6 months to detect events and deaths, which are adjudicated by experts. Systolic BP was categorized into <120 mmHg (n=4385), 120-129 mmHg (n=4000), 130-139 (n=2066), and hypertension was categorized into controlled (<140/90 mmHg on treatment) (n=8378), and uncontrolled (>140/90 mmHg) (n=5364). Incident acute CHD was defined as definite or probable myocardial infarction (MI) or acute CHD death. CVD death was defined as acute CHD, stroke, heart failure or other cardiovascular disease related. Cox proportional hazards models estimated the hazard ratios (HR) for incident CHD by BP categories, adjusting for sociodemographics and CHD risk factors. Results: The 23,393 participants free of CHD at baseline were followed for a median of 4.4 years. Mean age was 64.1, 58% were women and 42% were black. There was a significant interaction between sex and BP categories, therefore analyses were stratified by sex. There were 252 non-fatal and fatal acute CHD events among women and 407 among men. Among women, compared with SBP<120 mmHg, BP categories above SBP 120 mmHg were associated with incident CHD (adjusted HR for SBP120-129 mmHg=1.94 {95% CI 1.04-3.62]; SBP 130-139 mmHg=1.92 {0.95-3.87}; controlled HTN=2.16 {1.25-3.75}; uncontrolled HTN=3.25 {1.87-5.65}) in fully adjusted models. Among men, only uncontrolled HTN was associated with incident CHD (HR=1.55 {1.11-2.17}). Conclusion: In this sample, preHTN may be associated with incident CHD among women but not men.

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