Trident Health System - December 04, 2018

Smoking, diabetes, high blood pressure: all bad for the heart, but perhaps worse for women's hearts than men's, new research shows.

Looking at data on 472,000 Britons ages 40 to 69, researchers found that all three of these heart disease risk factors increased the odds of heart attack for both sexes.

But the rise in risk went even higher for women than men.

For example, while male smokers had more than twice the risk of heart attack than men who had never smoked, women smokers had more than three times the risk of heart attack than those who had never smoked, the study found.

The same trend held for high blood pressure and diabetes, according to the team led by Elizabeth Millett of the University of Oxford. High blood pressure was tied to a more than 80 percent higher risk for heart attack risk in women than in men; type 1 diabetes was associated with an almost three times higher risk in women than in men; and type 2 diabetes with a 47 percent higher risk in women than in men.

One risk factor – overweight or obesity – was associated with similar increases in heart attack risk in women and men, the researchers reported in The BMJ.

"Overall, more men experience heart attacks than women," Millett, an epidemiologist at Oxford's George Institute for Global Health, said in a university news release. "However, several major risk factors increase the risk in women more than they increase the risk in men, so women with these factors experience a relative disadvantage."

"These findings highlight the importance of raising awareness around the risk of heart attack women face, and ensuring that women as well as men have access to guideline-based treatments for diabetes and high blood pressure, and to resources to help them stop smoking," she said.

The findings reinforce that heart disease is certainly not a "males-only" disease.

“Cardiovascular disease is the leading cause of death among women in the United States,” said Dr. James T. Christmas, an obstetrician/gynecologist with Commonwealth Perinatal Associates in Richmond, Virginia, and HCA’s national medical director of Women’s and Obstetric Services. “Although estrogen levels during the reproductive years provide some protection to younger women, cardiovascular disease may present differently in women and has a higher mortality rate that in men.”

“Many of the risk factors for heart disease in women are similar to those in men: family history of cardiovascular disease, abnormal lipid profile, diabetes, high blood pressure, obesity, lack of exercise, and smoking. In addition, many of these risk factors have a greater impact on the risk of complications in women than in men,” he noted. “Women who have had pregnancies complicated by pregnancy induced hypertension or gestational diabetes have and increased risk of developing cardiovascular disease later in life. Likewise, women with a history of polycystic ovary syndrome are at increased risk of developing cardiovascular disease.”

Dr. Christmas suggested women, regardless of their age, should be encouraged to “address modifiable risk factors especially smoking, physical inactivity, obesity, poor diet, and medical conditions such as diabetes, high blood pressure and abnormal lipid levels.”

More information

The U.S. Office on Women's Health has more on women and heart attack.

Disclaimer: Content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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