Gender differences in coronary heart disease

### Learning objectives The importance of coronary heart disease (CHD) as a disease of both genders tends to be underappreciated, although in 2014 CHD claimed almost three times more lives than breast cancer. Just below one in five male deaths and one in ten female deaths were attributed to CHD. The British Heart Foundation's report in that same year states that CHD by itself is the biggest single cause of death in the UK.1 In general, women with CHD have worse outcomes than their male counterparts when no adjustments are made for other characteristics and comorbidities. Women tend to present with coronary artery disease later in life, and even when they present young they tend to receive less evidence-based treatment than their male counterparts.2 An important question is whether gender per se predisposes to higher cardiovascular risk. Much of the research in this field has been in the setting of acute myocardial infarction (AMI), with conflicting evidence from different studies. Some studies reported that gender is an independent risk factor for worse outcomes,3 while …