Tomás Abadal L
Rev Esp Cardiol. 1999 Jul;52(7):463-6. doi: 10.1016/s0300-8932(99)74952-3.
Coronary mortality among men is higher than in women in all age groups. Women seem to be protected from coronary disease. After the age of 50, coronary mortality increases fast in women and slows down in men, so that the mortality curves tend to join at some level. This fact led to believe that menopause had some influence over the non-proportional increase of coronary risk in women. Estrogens would be responsible for this protection before menopause and their further decrease would be the cause of higher coronary mortality. Mortality rate data, taken from a population with a high rate disease or a low rate disease, do not prove the above statement. For this reason it is said to by a myth. If it were a myth, then to try to prevent by administrating a substitute of these estrogens during menopause would be a paradox. If we accept that coronary atherosclerosis disease has many etiological factors, we should conclude that, besides hormones, there are other elements involved. The kind of personality, the way of life together with genetic factors related to gender would explain differences in frequency and mortality due to coronary heart disease, which, in this case, clearly advocates for women.
在所有年龄组中，男性的冠状动脉死亡率均高于女性。女性似乎对冠状动脉疾病具有一定的抵御能力。50岁之后，女性的冠状动脉死亡率迅速上升，而男性的死亡率上升速度则放缓，因此死亡率曲线在某一水平上趋于相交。这一事实让人认为，更年期对女性冠状动脉风险的非比例性增加存在一定影响。雌激素在绝经前起到这种保护作用，而其进一步减少则是冠状动脉死亡率升高的原因。从高发病率或低发病率人群中获取的死亡率数据并不能证明上述说法。因此，这被认为是一个误区。如果这是一个误区，那么在更年期通过服用这些雌激素的替代品来进行预防就会自相矛盾。如果我们承认冠状动脉粥样硬化疾病有多种病因，就应该得出结论，除了激素之外，还有其他因素在起作用。性格类型、生活方式以及与性别相关的遗传因素可以解释冠心病在发病率和死亡率上的差异，在这种情况下，女性显然更具优势。
