More men than women die from heart disease in most of the industrialized countries of the world. The most widely accepted explanation for this difference has been that women are protected by estrogen.

However, analysis of several national and international data sources reveals that environmental factors may play a larger role. Researchers examined data from as far back as 1921 from England and Wales, Australia, France, Japan, Sweden and the U.S. They found that deaths from heart disease vary over time and between countries in a way that cannot be explained by estrogen. Instead, they suggest that the differences in mortality are driven primarily by environmental factors. Specifically, they identified trends in fat consumption as a potential factor. As more men consumed more fat, more of them died from CHD. Among women, however, fat consumption did not increase to the same extent as men's, nor did deaths from CHD.

The researchers suggest that it may thus be possible to reduce the deaths in men to levels similar to those found in women by controlling environmental factors such as fat consumption.

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