Cardiovascular Risk: Men and Women are Now Equal—and Both Improving

University Professor and AARP Professor of Gerontology Eileen Crimmins

Both men and women over 50 reduced their risk factors for heart disease and stroke between 1990 and 2010, according to a new study from demographers at the University of Southern California, which also showed that differences between age and gender had largely gone away.

“Women and men are almost the same now and older people are almost the same as middle-aged people,” said senior author Eileen M. Crimmins, University Professor and AARP Professor of Gerontology at the USC Leonard Davis School of Gerontology.

The study credits decreasing rates of smoking and increased use and efficacy of prescription medications for reductions in high blood pressure and cholesterol levels. Crimmins noted that these findings of similar cardiovascular risk profiles for men and women may help explain why the life expectancy gap between men and women has been narrowing.

“We’ve always thought men and women are really different,” she said. “But now that we can control for risk factors that were worse for men, the women don’t look that different.”

The researchers found that both men and women decreased their mean number of cardiovascular risk factors, with the greatest improvement among those 60-69 years old. However, the improvements were paced differently. Men showed steady improvement over the two decades, while women’s gains occurred in the latter portion, from 2000 to 2010. In fact, there was an increase in cardiovascular risk among women aged 40-60 in 1990 and 2000, but by 2010, this was no longer the case.

The researchers also said that the use of hormone replacement therapy was unrelated to high risk blood pressure in women.

“It appears women were not being treated as frequently or as effectively as men for hypertension and high cholesterol,” Crimmins said. “But they are now.”

Indeed, the effectiveness of cholesterol medication appeared to consistently increase for both men and women. The percentage with controlled cholesterol rose from around 63 to over 95 percent for men, and from 65 to 88 percent for women, according to the study.

“Further medication-related reductions in cardiovascular risk and mortality may be increasingly difficult,” Crimmins said. “The use and efficacy of these medications may have helped counteract increases in indicators for obesity and diabetes since 1990.”

The researchers said that stopping smoking, eating healthier diets and increasing physical exercise could lead to more potential improvements. They also said that more research is needed on how increasing prevalence of atrial fibrillation and obesity will relate to cardiovascular health, dementia and mortality.

Crimmins and her colleagues used data of adults age 40 and older from the National Health and Nutrition Examination Survey to estimate total cardiovascular risk, the prevalence of individual risk factors and potential factors contributing to changes in risk. They compared measures for these risks on three dates about 10 years apart, between 1990 and 2010. Measures included systolic and diastolic blood pressure, body mass index (BMI), total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides and glycated hemoglobin (HbA1c) for blood glucose levels.

Crimmins’ coauthors included USC Leonard Davis Research Associate Professor Jung Ki Kim, the study’s first author, and USC Leonard Davis Assistant Professor Jennifer Ailshire. The study appeared online in Aging and Clinical Research on March 22.

Support for the research came from National Institute on Aging grants R24 AG045061 to the Network on Life Course Health Dynamics and Disparities, 2014-2019, with $326,398 total for fiscal year 2017, and P30 AG017265 for USC/UCLA Center for Biodemography and Population Health, 1999-2019, with $171,974 for fiscal year 2017.