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

Background: we examined whether type of menopause affects sex differences in coronary heart disease (chd) events and whether the impact is similar in blacks and whites.methods and results: participants were enrolled in the reasons for geographic and racial differences in stroke (regards) cohort between 2003 and 2007 without chd at baseline (n=23 086). cox regression models were used to calculate the hazard of incident nonfatal chd (definite or probable myocardial infarction) and acute chd death,adjusting for age,age at last menstrual period <45 years,region,education level,income,diabetes,smoking,systolic blood pressure,lipid levels,albumin-creatinine ratio,physical activity,c-reactive protein,body mass index,waist circumference,and medication use. white women in natural menopause (hazard ratio [hr],0.45; 95% confidence interval [ci],0.31,0.66) and surgical menopause (hr,0.65; 95% ci,0.42,0.99) had a reduced hazard of nonfatal events,compared to white men. black women in natural menopause (hr,0.69; 95% ci,0.47,1.03),but not surgical menopause (hr,0.81; 95% ci,0.51,1.29),had a marginally reduced hazard of nonfatal events,compared to black men. women had lower risk of acute chd death than men regardless of their menopause type and race.conclusions: 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 nonfatal events,regardless of menopause type. © 2015 the authors. published on behalf of the american heart association,inc.,by wiley blackwell.