Coronary artery disease epidemic in Pakistan: more electrocardiographic evidence of ischaemia in women than in men
2008

Gender Differences in Coronary Artery Disease in Pakistan

Sample size: 3143 publication Evidence: high

Author Information

Author(s): T H Jafar, Z Qadri, N Chaturvedi

Primary Institution: Aga Khan University, Karachi, Pakistan

Hypothesis

Are there gender differences in the prevalence of coronary artery disease (CAD) and its associated risk factors in urban Pakistan?

Conclusion

The study found that women in urban Pakistan have a higher prevalence of ECG abnormalities indicative of ischaemia compared to men, despite lower rates of definite CAD.

Supporting Evidence

  • Women had more CAD risk factors than men, including diabetes, hypertension, and obesity.
  • Definite CAD was more prevalent in men (6.1%) than in women (4.0%).
  • Ischaemic ECG changes were twice as prevalent in women (29.4%) compared to men (15.6%).
  • The metabolic syndrome was a strong predictor of CAD in both genders.

Takeaway

In Pakistan, more women than men show signs of heart problems on ECG, even though fewer women are diagnosed with heart disease by doctors.

Methodology

A population-based, cross-sectional survey was conducted on 3143 adults aged 40 years and older from 12 randomly selected communities in Karachi, Pakistan.

Potential Biases

Potential bias due to gender differences in healthcare seeking behavior and diagnostic preferences.

Limitations

The study did not directly measure atherosclerosis or infarcts, and doctor-diagnosed heart attacks were not adjudicated.

Participant Demographics

Participants were adults aged 40 years and older, with a mean age of 51.6 years, including 1503 men and 1640 women.

Statistical Information

P-Value

p<0.001

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1136/hrt.2007.120774

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