Heart disease has today emerged as the leading cause of death in the world. It is estimated that from the late 1980s, coronary artery disease has been the cause of death for more women every year than men. As the incidence of heart disease has grown, so have the risk factors for heart disease. Diabetes, high blood pressure, smoking, excess consumption of alcohol, and being overweight are some of the well-known risk factors for heart disease or a heart attack. But is it that these factors affect the risk of heart disease in men and women equally? Research has now found that there is no doubt that these risk factors increase the risk of a heart attack in both men and women, but it is to a much greater extent in women. Read on to find out about why women have a higher risk of heart attack than men.

Are Women at a Higher Risk of Heart Attack than Men?

Some of the well-known risk factors for a heart attack include uncontrolled diabetes, high blood pressure, high cholesterol, smoking, and excessive drinking.^{(1,2,3,4,5,6)}However, do these factors pose the same risk in men and women?⁽⁷⁾

According to a 2018 study, while these risk factors increased the likelihood of a heart attack in both men and women, but the risk was significantly higher in women.⁽⁸⁾ The study was carried out by researchers from the John Hopkins University, University of Oxford, and some other institutions. They went through data of nearly half a million people who are enrolled in the UK Biobank. The UK Biobank is an information database that collects data from adults all over the United Kingdom.⁽⁹⁾

The researchers discovered that high blood pressure increased the risk of a heart attack in a woman by 83 percent more than it did in a man. At the same time, having type 2 diabetes increased the risk of a woman by 47 percent more than a man and smoking increased the risk of a heart attack by 55 percent more in a woman than a man.

The authors of the study claimed that while the exact reasons for these findings remained unclear, but it is likely related to other confounding factors, including the duration of exposure to these heart attack risks. For example, women could have had uncontrolled or untreated high blood pressure for a longer time than men.

Furthermore, women often tend to overlook their risk factors for heart disease, ignoring warning signs, and taking longer to seek treatment. When they finally seek treatment, they are significantly less likely than men to be treated with the correct guideline-based therapies.

Lesser Studies Done on Women

According to the US Centers for Disease Control and Prevention (CDC), heart disease has been a leading cause of death of both women and men in the United States for some years now.⁽¹⁰⁾ In fact, the organization estimates that one person dies every 37 seconds in the US alone from heart disease.⁽¹¹⁾

However, what is surprising to note is that studies on heart disease have focused on more men than women for the last so many decades. In many cases, researchers have excluded women from the studies due to concerns about the potential risks the treatments involved in the study might pose to a developing fetus if a woman participant became pregnant during the study.

The changing hormonal levels of women during the entire menstrual cycle was also counted as a concern that could confound the results of the study. This would have made it more challenging and expensive to collect and analyze the data from a population set that included female subjects as well.

Due to these factors and many others, men have been historically given preference and selected as the default subjects in most of the research studies done on heart disease.

However, it has become increasingly apparent over the years that gender has a profound effect on how heart disease impacts different people. Until now, it was assumed that there is no difference between how these risk factors affect men and women, but this study has emphasized that women respond in a different manner than men. The effect of these risk factors is actually much higher on women than on men.

Managing the Risk Factors

Many studies have shown that risk factors such as hypertension (high blood pressure), diabetes, and smoking increase the risk of having a heart attack in both men and women. At the same time, more studies are now establishing that these risk factors can translate into a higher risk for a heart attack in women as compared to their effect on men.

There are several other risk factors also that have been found to increase the risk of heart disease in women. For example, pregnancy-related complications such as pre-eclampsia, gestational diabetes, gestational hypertension, low infant birth weight, and preterm delivery are all known to be associated with a greater risk of heart disease in women.^(12,13,14)

At the same time, certain health conditions can also increase the risk of heart disease in women. These include lupus, rheumatoid arthritis, and breast cancer.^(15,16,17)
In order to manage this increased risk of heart disease, women should talk to their doctors before time itself so that they can start taking precautions from before.
It is essential for women to be aware that they are at an increased likelihood of heart disease and discuss their risk factors with their doctor so that they can be addressed well before time.

For example, exercise, smoking, diet, and other detrimental lifestyle habits can be addressed early on in life so that it can cut down the chances of developing high blood pressure, diabetes, and heart disease later on.

Conclusion

Researchers have found that women are at a higher risk of having a heart attack by nearly 83 percent more than in men. Type 2 diabetes, smoking, high blood pressure, and several other risk factors have been found to increase the risk for women many times as compared to men. Following a healthy lifestyle, eating healthy, increasing physical activity and fitness, and discussing your risk factors with your doctor ahead of time can all help cut down the risk of heart disease in women.

References:

Barrett-Connor, E. and Khaw, K.T., 1988. Diabetes mellitus: an independent risk factor for stroke?. American journal of epidemiology, 128(1), pp.116-123.
Cruickshank, J.K., Beevers, D.G., Osbourne, V.L., Haynes, R.A., Corlett, J.C. and Selby, S., 1980. Heart attack, stroke, diabetes, and hypertension in West Indians, Asians, and whites in Birmingham, England. British medical journal, 281(6248), p.1108.
Cushman, W.C., Ford, C.E., Cutler, J.A., Margolis, K.L., Davis, B.R., Grimm, R.H., Black, H.R., Hamilton, B.P., Holland, J., Nwachuku, C. and Papademetriou, V., 2002. Original Papers. Success and Predictors of Blood Pressure Control in Diverse North American Settings: The Antihypertensive and Lipid‐Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). The Journal of Clinical Hypertension, 4(6), pp.393-404.
Castelli, W.P., 1988. Cholesterol and lipids in the risk of coronary artery disease–the Framingham Heart Study. The Canadian journal of cardiology, 4, pp.5A-10A.
Dobson, A.J., Alexander, H.M., Heller, R.F. and Lloyd, D.M., 1991. How soon after quitting smoking does risk of heart attack decline?. Journal of clinical epidemiology, 44(11), pp.1247-1253.
Steinberg, D., Pearson, T.A. and Kuller, L.H., 1991. Alcohol and atherosclerosis. Annals of internal medicine, 114(11), pp.967-976.
Hamil-Luker, J. and Angela, M., 2007. Gender differences in the link between childhood socioeconomic conditions and heart attack risk in adulthood. Demography, 44(1), pp.137-158.
Millett, E.R., Peters, S.A. and Woodward, M., 2018. Sex differences in risk factors for myocardial infarction: cohort study of UK Biobank participants. bmj, 363, p.k4247.
Ukbiobank.ac.uk. 2020. UK Biobank. [online] Available at: <https://www.ukbiobank.ac.uk/> [Accessed 12 June 2020].
Centers for Disease Control and Prevention. 2020. Heart Disease Facts | Cdc.Gov. [online] Available at: <https://www.cdc.gov/heartdisease/facts.htm> [Accessed 12 June 2020].
Heron, M.P., 2016. Deaths: leading causes for 2013.
Smith, G.C., Pell, J.P. and Walsh, D., 2001. Pregnancy complications and maternal risk of ischaemic heart disease: a retrospective cohort study of 129 290 births. The Lancet, 357(9273), pp.2002-2006.
Sattar, N. and Greer, I.A., 2002. Pregnancy complications and maternal cardiovascular risk: opportunities for intervention and screening?. Bmj, 325(7356), pp.157-160.
Sattar, N., 2004. Do pregnancy complications and CVD share common antecedents?. Atherosclerosis Supplements, 5(2), pp.3-7.
Darby, S.C., Ewertz, M., McGale, P., Bennet, A.M., Blom-Goldman, U., Brønnum, D., Correa, C., Cutter, D., Gagliardi, G., Gigante, B. and Jensen, M.B., 2013. Risk of ischemic heart disease in women after radiotherapy for breast cancer. New England Journal of Medicine, 368(11), pp.987-998.
Bruce, I.N., Urowitz, M.B., Gladman, D.D., Ibañez, D. and Steiner, G., 2003. Risk factors for coronary heart disease in women with systemic lupus erythematosus: the Toronto Risk Factor Study. Arthritis & Rheumatism, 48(11), pp.3159-3167.
Kitas, G.D. and Erb, N., 2003. Tackling ischaemic heart disease in rheumatoid arthritis.

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Are Women at a Higher Risk of Heart Attack than Men?