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[An alternative hypothesis explaining the gender differences in risk of coronary heart disease].

One of the most interesting aspects of coronary heart disease epidemiology is the gender difference: in all age groups women have lower risk of myocardial infarction compared to men. Epidemiological observations and results of recent controlled clinical trials suggest that it is not oestrogen that protects women. In this paper an alternative hypothesis is suggested: Men are at increased risk of coronary death and myocardial infarction because they are more prone than women to develop lipid-loaded, unstable coronary atherosclerotic plaques. This may be caused by gender differences in plasma levels of high density lipoprotein cholesterol, which is influenced by the blood testosterone level.