Abstract
This study aimed to describe the prevalence of gender disparity in cardiovascular disease and explore its association with a country’s capacity for controlling noncommunicable diseases. Study data were extracted from the Global Health Estimates, and the Noncommunicable Disease Country Capacity Survey. Age-standardized premature death rates from cardiovascular disease, defined as any death occurring from ages 30 to 70 years, were calculated. Univariate and multivariate general linear regression models were fitted to estimate the correlations between gender disparity and country capacity for noncommunicable disease control. Globally, the premature death rate from cardiovascular diseases was 35.6% higher among men than women in 2000, and the figure hardly changed from 2000 to 2016. The highest gender differences were observed in Europe and high-income countries. The existence of dedicated and multisectoral noncommunicable disease governance bodies and the availability of cardiovascular disease stratification in primary healthcare facilities were positively correlated with gender differences. Conclusively, gender disparities in premature death rates from cardiovascular diseases differed with economic conditions and across geographic regions, with higher relative differences observed in more developed countries. The effects of existing control measures may have plateaued in men but are ongoing among women, especially in more developed countries, widening the gender disparity.
Highlights
Despite dramatic declines in mortality rates over the past decades in most countries and globally [1,2], cardiovascular disease (CVD) remains the leading cause of premature deaths for both genders [3]
We found that the existence of an operational unit in the ministry of health with responsibility for noncommunicable diseases (NCDs) is prevalent in many World Health Organization (WHO) member states, usually increasing with national income level
We found geographic and temporal variations in gender differences in premature
Summary
Despite dramatic declines in mortality rates over the past decades in most countries and globally [1,2], cardiovascular disease (CVD) remains the leading cause of premature deaths for both genders [3]. CVD, including coronary heart disease and stroke, accounts for nearly half of all premature deaths globally [1,2], and the economic burden of the condition is considerable in both developed and developing settings [4–6]. In 2013, the member states of the World Health Organization (WHO) committed to achieving a 25% reduction in premature deaths from CVD and three other major noncommunicable diseases (NCDs) by 2025 [7]. The incidence of, and mortality from, ischemic heart disease are higher in men than in women under the age of 65 years [1,8]. The gender differences narrow after 65, probably because women lose the protective effect of estrogen after menopause [1,8].
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