Women or Men — Who Has a Higher Risk of Heart Attack?
A woman’s heart may look just like a man’s, but there are significant differences. Learn about the factors that affect a woman’s risk of coronary artery disease and heart attacks.
Contributor: Leslie Cho, MD
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A woman’s heart may look just like a man’s, but there are significant differences.
For example, a woman’s heart is usually smaller, as are some of its interior chambers. The walls that divide some of these chambers are thinner. And while a woman’s heart pumps faster than a man’s, it ejects about 10 percent less blood with each squeeze.
When a woman is stressed, her pulse rate rises, and her heart pumps more blood. When a man is stressed, the arteries of his heart constrict, raising his blood pressure.
Why do these differences matter? They matter because gender plays a role in the symptoms, treatments and outcomes of coronary artery disease (CAD).
Certain diseases that only affect women increase the risk of coronary artery disease, the leading cause of heart attack. These include endometriosis, polycystic ovary disease, diabetes and high blood pressure that develop during pregnancy. Endometriosis has been found to raise the risk of developing CAD by 400 percent in women under age 40.
Women also share traditional risk factors with men: high blood pressure, high blood sugar levels, high cholesterol levels, smoking and obesity. Like men, women can be impacted by a family history of heart disease, particularly when a father or brother was diagnosed with CAD before age 55, or a mother or sister was diagnosed before age 65.
Men are at risk for heart attack much earlier in life than women. Estrogen offers women some protection from heart disease until after menopause, when estrogen levels drop. This is why the average age of for a heart attack is 70 in women, but 66 in men.
Chest pain (also described as a crushing weight on the chest) is the most common symptom of heart attack in men. Some women also experience chest pain, but they are more likely to have different symptoms. Unlike the dramatic, chest-clutching pain seen in the movies, women often experience subtler symptoms for three or four weeks before a heart attack. Red flags include:
An X-ray movie (angiogram) taken during a cardiac catheterization is the gold standard test for finding narrowings or blockages in the heart’s large arteries.
But CAD in women often affects the small arteries, which cannot be clearly seen on an angiogram. That’s why any woman who is given the “all clear” signal after an angiogram and continues to have symptoms should see a cardiologist who specializes in women with heart disease.
Women don’t tend to do as well as men after a heart attack. They often require a longer hospital stay, and they are more likely to die before leaving the hospital.
This may be due to the fact that women who suffer a heart attack have more untreated risk factors, such as diabetes or high blood pressure. Sometimes, it’s because they put their families first and don’t take care of themselves.
After a heart attack, women are at greater risk of developing a blood clot that can cause another heart attack. For unknown reasons, they are not as likely to be given a drug to prevent such blood clots. This could explain why women are more likely than men to have a second heart attack within 12 months.
Whether you are a man or a woman, it’s never too late to lower your chance of suffering a heart attack. Here is what you need to do:
It’s important for all of us to be proactive in reducing our heart attack risk.