Sex differences in cardiovascular disease burden, risk factors, and disease spectrum in Europe: a global burden of disease 2023 analysis within the European Society of Cardiology (ESC) Atlas framework
Authors' conclusion
These findings challenge conventional approaches that treat CVD as a homogeneous condition. In particular, the substantial contribution of non-ischaemic conditions and maternal hypertensive disorders to the burden in women, alongside distinct patterns of risk exposure and wider geographic disparities, underscore the importance of adopting a life-course and sex- and gender-informed approach to cardiovascular prevention and policy.
Study context
- Population
- 55 European Society of Cardiology (ESC) member countries, data from the 2023 Global Burden of Disease study
- Comparison
- Sex-specific patterns in cardiovascular disease (CVD) burden and risk factor exposure
- Outcome
- Overall CVD burden in the ESC region
- Follow-up
- 2023
Methodological detailsage-sex-standardized rates per 100 000 person-years using the 2013 European Standard Population, country, regional, and ESC-wide levels, over time (1990-2023)
- Age-sex-standardized rates per 100 000 person-years using the 2013 European Standard Population
- Country, regional, and ESC-wide levels
- Over time (1990-2023)
Main finding
As reported in the abstract
| Group | Share of cases | Share of deaths |
|---|---|---|
| Women | 55% (6.0 million) | 50% (1.5 million) |
Women
Further findings
Proportion of CVD due to ischaemic heart disease · 2023
Contribution from peripheral arterial disease · 2023
Summary exposure values of risk factors
- Tobacco and alcohol higher in men than women
- 10%-20% points
- High body mass index and low physical activity often higher in women than men
- 5%-15% points
- More modest differences in air pollution, fasting glucose, or cholesterol
Between-country variation in CVD incidence and mortality
- Difference between lowest- and highest-incidence countries in women
- approximately three-fold
- Difference between lowest- and highest-incidence countries in men
- two-fold
- Disparities in mortality and premature mortality in women
- up to 25-fold
Maternal hypertensive disorders
- Share of incident CVD in women
- 25%
- Differences in incidence across countries
- up to 18-fold
Original publication
Summarised from the published abstract; every number is checked against it