To the Editor: The observational study by Dr Krumholz and colleagues1 showed a reduction in hospital risk-standardized mortality rate (RSMR) in patients with acute myocardial infarction (AMI) between 1995 and 2006. The study missed the opportunity to analyze whether this decrease applied to female and male patients to a similar extent.
Diseases may affect women differently than men.2 The major risk factors for coronary heart disease in women are similar to those in men (presence of hypertension and smoking), but relative differences in the effect of diabetes mellitus and the metabolic changes associated with the aging process are embedded in the menopausal transition. Late-onset diabetes is more prevalent in aging women than in men.3 Women with diabetes appear to receive less medical attention regarding control and treatment of cardiovascular disease risk factors.4
Dören M. Hospital Mortality in Acute Myocardial Infarction. JAMA. 2010;303(2):132–134. doi:10.1001/jama.2009.1970
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