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It has become evident that there are sex differences in coronary heart disease (CHD) presentation, treatment and outcomes, and there is excessive CHD mortality in women compared with men now observed worldwide (figure 1).1 Given the high global burden of CHD, it is imperative to gain an understanding of sex differences in risk factor control in contemporary practices in various regions of the world. Zhao et al2 report on risk factor management for secondary prevention of CHD in three regions (Europe, Asia and the Middle East) from 2012 to 2013 in the SUrvey of Risk Factors (SURF) study. They found that risk factor management is less in women than men and that sex differences varied by region. Overall, cardiovascular health index score, age adjusted, was better in Asia, and modestly worse in Europe and the Middle East in women compared to men. The SURF extends existing literature on sex differences in CHD risk factor control to women in Asia and the Middle East, although the results may not be representative of a region. For instance, Saudi Arabia alone represented the Middle East, while 60% overall of participants were from Europe. Nevertheless, this study documents the need for region/country specific data to shape specific policy and priorities.
Women comprised less than one-third of the participants in the current registry, comparable with other international registries of stable and unstable ischaemic heart disease (IHD), …
Contributors All authors have contributed equally to the design of the work, the acquisition and interpretation of data, the drafting and revision of the work and have approved of the final manuscript.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.