Gender-specific associations between coronary heart disease and other chronic diseases: cross-sectional evaluation of national survey data from adult residents of Germany

J Geriatr Cardiol. 2019 Sep;16(9):663-670. doi: 10.11909/j.issn.1671-5411.2019.09.004.

Abstract

Background: Combinations of coronary heart disease (CHD) and other chronic conditions complicate clinical management and increase healthcare costs. The aim of this study was to evaluate gender-specific relationships between CHD and other comorbidities.

Methods: We analyzed data from the German Health Interview and Examination Survey (DEGS1), a national survey of 8152 adults aged 18-79 years. Female and male participants with self-reported CHD were compared for 23 chronic medical conditions. Regression models were applied to determine potential associations between CHD and these 23 conditions.

Results: The prevalence of CHD was 9% (547 participants): 34% (185) were female CHD participants and 66% (362) male. In women, CHD was associated with hypertension (OR = 3.28 (1.81-5.9)), lipid disorders (OR = 2.40 (1.50-3.83)), diabetes mellitus (OR = 2.08 (1.24-3.50)), kidney disease (OR = 2.66 (1.101-6.99)), thyroid disease (OR = 1.81 (1.18-2.79)), gout/high uric acid levels (OR = 2.08 (1.22-3.56)) and osteoporosis (OR = 1.69 (1.01-2.84)). In men, CHD patients were more likely to have hypertension (OR = 2.80 (1.94-4.04)), diabetes mellitus (OR = 1.87 (1.29-2.71)), lipid disorder (OR = 1.82 (1.34-2.47)), and chronic kidney disease (OR = 3.28 (1.81-5.9)).

Conclusion: Our analysis revealed two sets of chronic conditions associated with CHD. The first set occurred in both women and men, and comprised known risk factors: hypertension, lipid disorders, kidney disease, and diabetes mellitus. The second set appeared unique to women: thyroid disease, osteoporosis, and gout/high uric acid. Identification of shared and unique gender-related associations between CHD and other conditions provides potential to tailor screening, preventive, and therapeutic options.

Keywords: Chronic diseases; Comorbidities; Gender; Heart disease; Risk factors; Survey data.