Skip Navigation

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by COHN, B. A.
Right arrow Articles by KAPLAN, G. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by COHN, B. A.
Right arrow Articles by KAPLAN, G. A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

American Journal of Epidemiology Vol. 131, No. 3: 434-442
Copyright © 1990 by The Johns Hopkins University School of Hygiene and Public Health

research-article

SEX DIFFERENCES IN TIME FROM SELF-REPORTED HEART TROUBLE TO HEART DISEASE DEATH IN THE ALAMEDA COUNTY STUDY

SIGNIFICANCE OF TIME DEPENDENCE OF RISK VARIABLE EFFECTS

BARBARA A. COHN1,, DEBORAH L. WINGARD2, RICHARD D. COHEN1, PIERA M. CIRILLO1 and GEORGE A. KAPLAN3

1Human Population Laboratory, California Public Health Foundation Berkeley, CA
2Department of Community and Family Medicine, M-007, University of California at San Diego La Jolla, CA
3Human Population Laboratory, California Department of Health Services Berkeley, CA

Reprint requests to Dr. Barbara A. Cohn, Human Population Laboratory, California Public Health Foundation, 2151 Berkeley Way, Annex 2, Room 302, Berkeley, CA 94704

In a previous analysis from the Alameda County Study, it was observed that although men had higher heart disease mortality rates than women, there was no male excess in the prevalence of self-reported heart disease morbidity at baseline or in new reports of morbidity 9 years past baseline. This apparent contradiction might occur because women report less severe heart disease than men. In the present study, this hypothesis was evaluated by examining whether self-reported heart trouble was more strongly associated with subsequent heart disease mortality for men than for women in a representative sample of the population of Alameda County, California, selected in 1965 and followed for mortality for 19 years (n = 3,742). In a time-dependent Cox model, self-reported heart trouble was a stronger predictor of heart disease mortality for men,but only during the early years of follow-up (p = 0.00). This effect was due to a shorter time to death for men who reported heart trouble. The relative hazard for men reporting heart trouble was 6.6 (95% confidence interval (Cl) 3.7–11.6) at baseline, declining to 3.2 (95% Cl 2.2–4.5) by 5 years past baseline and 1.5 (95% Cl 0.9–2.5) by 10 years past baseline. Self-reported heart trouble was a consistent predictor of subsequent heart disease mortality for women over the 19-year follow-up period (relative hazard = 2.0, 95% Cl 1.4–2.8). Sex differences in the prognosis of self-reported heart trouble were masked in non-time-dependent analyses. These results illustrate that consideration of time dependence may be required for meaningful analysis of long-term cohort studies. Possible explanations of the shorter time to death for men who reported heart trouble are discussed.

coronary disease; morbidity; mortality, prospective studies; sex factors; survival; time factors


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.