Sex differences are increasingly being studied to assess symptoms, risk factors, and outcomes for various diseases, but a new study suggests gender—not sex—is a better way to gauge the risk an adult will have a second heart attack.
“Our study suggests that adults with role and personality traits traditionally ascribed to women have an increased risk of recurrence of premature acute coronary syndrome (ACS) or major adverse cardiac events within 12 months following their first incident, regardless of their biological sex,” says Louise Pilote, professor of medicine at McGill University.
“It is therefore important, as researchers, to consider gender in addition to biological sex when we analyze the differences between men and women for various diseases.”
The study, published in the Journal of the American College of Cardiology, included approximately 1,000 participants from across Canada aged 18 to 55 who had been hospitalized for an ACS between January 2009 and April 2013.
The participants were from the cohort GENESIS-PRAXY (Gender and Sex determinants of cardiovascular disease: from bench to beyond: Premature Acute Coronary Syndrome), which was created to determine the differences associated with sex (biological and physiological characteristics) and gender (i.e., gender identity, role in society, socioeconomic status, and interpersonal relationships) in men and women suffering from heart disease.
“Patients involved in the study, who had presented with an ACS, were asked to complete an elaborate questionnaire related to gender,” says first author and clinical psychologist Roxanne Pelletier. “The questions addressed different aspects of gender as traditionally ascribed to men and women in society such as the number of hours that the person spends carrying out household chores or taking care of children, the person’s salary.”
Researchers then developed a gender index ranging from 1 to 100 points, going from a very high level of characteristics traditionally ascribed to men (1 point) to another extreme of characteristics traditionally ascribed to women (100 points).
“We observed that participants with a very high score of traditional feminine characteristics, regardless of whether they were biologically a man or a woman, were more likely to have a second cardiac event,” Pelletier says.
“In our cohort, characteristics traditionally ascribed to females seemed to adversely affect health outcomes, potentially though increased anxiety related to those characteristics,” Pilote says.
“There are likely multiple reasons to explain the presence of increased anxiety in men and women with characteristics traditionally ascribed to women in our sample. For example, financial difficulties and/or the need to manage housework, child care, and work may represent a daily burden and chronic anxiety may result.”
Source: McGill University