Coronary heart disease (CHD) is the leading cause of death among women in the United States, which had 7.5 million women with a history of CHD in 2008, surpassing the 2.6 million women with a history of breast cancer who were alive in 2008. Furthermore, 515,000 women were diagnosed with myocardial infarction (MI) and fatal CHD, exceeding the 230,480 women who were diagnosed with breast cancer in 2008. A telephone survey conducted by the American Heart Association in 2006 and 2009 found that 65% of white women but only 37% and 38% of black and Hispanic women, respectively, were aware of CHD (not breast cancer) as the leading cause of death among women. Younger women (age <55 years), in particular, were less aware of both the high mortality and the risk factors for CHD. Our objectives in this editorial were to (1) examine the role of age when comparing CHD with breast cancer mortality in women and (2) discuss how these insights on mortality and age may be used in promoting women’s health.
From 1980 to 2009, age-adjusted death rates from CHD have decreased by about 2/3, whereas such rates for breast cancer have decreased by about 1/3 ( Table 1 ). In 1980, a woman was 8.2× more likely to die of CHD than of breast cancer; by 2009, a woman was still 3.9× more likely to die of CHD than breast cancer. These age-adjusted data, although, mask the effect of age when examining mortality attributed to CHD and breast cancer among women. Table 2 lists age-stratified death rates that compare the risk of death from CHD versus death from breast cancer in 2009. Among subjects aged 25 to 35 years or 35 to 44 years, women were about 1/3 less likely to die of CHD compared with breast cancer ( Table 2 ). However, the number of women affected in either disease category was relatively small. Women aged 45 to 54 years had an almost equal risk of dying from CHD or breast cancer. In the postmenopausal age groups, death from CHD surpasses that of breast cancer among women, with a 1.4-fold greater risk of dying from CHD than breast cancer for women aged 55 to 64 years, to a 14-fold greater risk for women aged ≥85 years.
| Variable | Year | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1980 | 1990 | 1995 | 1997 | 1998 | 1999 | 2000 | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | |
| CHD | 263.1 | 193.9 | 173.6 | 160.9 | 155.6 | 152.9 | 146.5 | 139.9 | 133.6 | 127.2 | 116.7 | 111.7 | 103.1 | 95.7 | 93.0 | 86.2 |
| Breast cancer | 31.9 | 33.3 | 30.8 | 28.6 | 27.9 | 26.6 | 26.8 | 26.0 | 25.6 | 25.2 | 24.5 | 24.1 | 23.5 | 22.9 | 22.5 | 22.3 |
| Risk ratio ∗ | 8.2 | 5.8 | 5.6 | 5.6 | 5.6 | 5.7 | 5.5 | 5.4 | 5.2 | 5.0 | 4.8 | 4.6 | 4.4 | 4.2 | 4.1 | 3.9 |
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