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CHD Down 14%. inMen, Unchanged in Women 50-59 Inlernarional Medical News Senice TUCSON - The incidence of coro- nary heart disease in 50- to 59-year-old women remained unchanged between 1950 and 1980, while men in the same age group showed a 14% drop in hew cases, according to data from the Framingham Heart Study, Elaine D. ~ Eaker, Sc.D., said at the annual con- ference on cardiovascular disease epi- demiology sponsored by the American Heart Association. Another noteworthy difference be- tween women and men in the Framing- ham Study is that glucose intolerance is a powerful risk factor for coronary heart disease (CHD) in women but not in men, said Dr. Eaker, an epidemiolo- gist at the National Heart, Lung, and Blood Institute, Bethesda, Md. She reported on 2,366 women and 2,220 men, all of whom were 50-59 -- years old and free of CHD at the time of their baseline medical examination in 1950, 1960, or 1970. %We Information about morbidity . and mortality has been collected every 2 years in the Framingham Study, mak- ing possible accurate assessment of the 10-year incidence of CHD during each of the past three decades. The 10-year incidence of eHn, in- cluding angina, has remained stable at about 8% in 50- to 59-year-old women in Framingham. The incidence in men of the same age group was about twice as great as in women in 1950, but it has since declined. There has never been a comparable nationwide study of CHD incidence, so whether the Framingham experience is representative of the whole country is not known.. In recent decades, the most striking change in CHD risk factors in the Fra- mingham women has been in cigarette smoking. Twice as many women in the 50-59 age group in 1970 were smokers, compared with women en of the same age in 1950. By 1970, equal percentages of women and men in the study population were smokers, Dr. Eaker noted. Blood pressure, relative body weight, tional risk factors were equally predic$'. ~` and serum cholesterol dropped in the tive of heart diseas_e_ in men and women women from 1950 to 1970. Blood pres- The basis of women's protcetion - sure and relative weight went from sig-- against CHD is still unclear. Among nificantly higher to lower than in men subjects free of all mJor cHn risk - from 1950 to 1970, while serum cho- factors, the relative risk of heart dis- lesterol remained persistently higher ease remained 3.78 times greater in - than in men. men than in women, Dr. Eaker pointed - Women with glucose intolerance had out. more than three times the increased Some other investigators have re- relative risk for developing CHD within ported that premature menopause ap-a a decade, compared with women who pears to cause women to lose their were not glucose intolerant at baseline. -Protection against ctto-.That wasn't the The next most powerful risk factor was case here. The risk of heart disease was cigarette smoking, which carried a not increased in the 50- to 59-year-old nearly twofold increased risk. e Framingham women with early mena ' rom Angina pectoris was excluded f the definition of CHD for this analysis, since up to 50% of women who com- plain of angina lack significant arterial occlusion. Glucose intolerance was more preva- lent in men but was not predictive of - CHD in them. The explanation for this difference between the sexes isn't known. Smoking and the other conven- r pause. pause. Although postmenopausal women had higher rates of heart disease than premenopausal women, this difference disappeared after age, cigarette smok- ing, blood pressure, serum cholesterol, and glucose intolerance were taken into account, she said. The risk of heart disease in the 784 women with surgical menopause was not different from that of the 1,934 women with. natural menopause. This was true regardless of whether one, both, or no ovaries were removed, she - - said. It would be erroneous, however, to conclude that oophorectomy doesn't in- crease crease risk of heart disease; women in Family Practice News May 1 5-31 , 1985 the 50- to 59-year-old group have non- functioning ovaries. The only way to an- swer this question will be to study younger women, Dr. Eaker said. - - - Her associates in this study were Dr. William Castelli and Robert Gar- rison. rison.