Differences in cardiovascular disease risk between men and women in a multi-ethnic population: Let’s talk about sex and gender

Since men are generally at higher cardiovascular disease (CVD) risk than women, previous research has mainly focussed on men. As a consequence, CVD has been understudied in women, and the causes underlying the differences in CVD risk between men and women are still poorly understood. Additionally, ethnic disparities in CVD risk within populations are well-known, but few studies have investigated whether differences in CVD risk between men and women vary by ethnicity. Thus, the general aim of this thesis was to enhance our understanding of differences in CVD risk between men and women across ethnic groups, and of the sex- and gender-related factors associated with these differences.
The studies included in this thesis confirm previous evidence that CVD risk is generally lower in women than in men. However, depending on the type of CVD, the female advantage was relatively small in some ethnic minority groups. Therefore, women from ethnic minority groups, specifically women of South-Asian Surinamese and Turkish origin, may pose an important target group for additional prevention strategies. In addition, our findings indicate that (sociocultural) gender characteristics are relevant for cardiovascular health, mainly in women. Female homemakers may particularly form an additional target group due to their increased risk of CVD. If our findings are confirmed in future research, gender characteristics, specifically related to division of paid and unpaid labour, may pose valuable additional factors for the identification of CVD risk groups, especially for women.