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The male excess in coronary heart disease (CHD) is well recognised. Nevertheless, CHD is the leading cause of death in women as well as men in most industrialised countries.1–4 In the United Kingdom in 2002, coronary heart disease accounted for approximately 64 000 (22%) of the 288 000 deaths or one in five deaths in men, and 53 000 (17%) of the 318 000 deaths, or one in six death in women at all ages.1–3
CHD MORTALITY RATES, INTERNATIONAL COMPARISONS AND TIME TRENDS
Table 1 shows mortality rates for CHD by age and sex in the United Kingdom and also the ratio in men compared to women. The male excess for CHD is most pronounced at younger ages but still apparent throughout life. Age standardised CHD mortality rates by sex for selected countries between 1999–2000 are shown in fig 1,2,3 illustrating enormous international variations. The highest documented rates are now seen in countries in Eastern Europe with women in these countries having over 10-fold the rates of women in Japan. A male excess in CHD is evident in all countries; nevertheless, the CHD rates in men and women internationally correlate strongly. Time trends for selected countries from 1969 to 2001,2,3 shown in fig 2 illustrate different patterns in these countries. Both the United States and United Kingdom have …