Abstract
Objective: The goal of this study was to determine the effect of religion on occurrence of cardiovascular in diseases in a large prospective cohort of postmenopausal women. Methods: The data were analyzed for 80,805 women 50-79 years of age who were enrolled in the observational arm of the Women’s Health Initiative Study. The effect of religion (Catholic, Protestant, and Jewish) on risk of ischemic stroke, hemorrhagic stroke, any stroke, myocardial infarction, and cardiovascular deaths was determined over a period of 12 ± 1 years (mean ± SD) using Cox proportional hazards analysis after adjusting for age, ethnicity, body mass index, systolic blood pressure, cigarette smoking, atrial fibrillation, and congestive heart failure. Results: Of the 80,805 participants, 48301, 25390, and 7114 women reported the religion as Protestants, Catholics, and Jewish, respectively. The mean (SD) systolic blood pressure was significantly lower in Jewish women (124.3 [18.0], p<0.001) and Catholic women (126.7[17.7, p<0.001) compared with Protestant women (127.8[18]). Jewish women had significantly lower rates of diabetes, mellitus, atrial fibrillation, and active cigarette smoking. Compared with Catholic women, Jewish women had a significantly lower risk of ischemic stroke (hazards ratio [HR] 0.78, 95% confidence interval [CI] 0.65-0.94, p<0.008), any stroke (HR 0.78, 95% CI 0.67-0.92, p<0.008), and cardiovascular death (HR 0.79, 95% CI 0.66-0.96, p=0.02). No difference was noted in the risk of myocardial infarction (HR 0.91, 95% CI 0.78-01.1, p=0.2). There were no differences in the risk of ischemic stroke, any stroke, myocardial infarction, and cardiovascular death between Catholic and Protestant women. Conclusions: There appeared to be a lower risk of any stroke and ischemic stroke (bout no myocardial infarction) among post-menopausal Jewish women. Further studies may identify the underlying reasons for the observed difference and may have implications for identifying innovative preventive strategies.
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