WHEN IT COMES to heart health, gender can influence everything from heart disease risk factors to heart attack symptoms.
Many women believe that the men in their lives have a greater risk of heart disease than they do. But more than 6.5 million American women live with some form of heart disease, according to Harvard Medical School. In fact, the disease is the leading cause of death for men and women in the U.S. Even though heart disease doesn’t discriminate, it can affect women differently.
AGING AND THE FEMALE HEART
Men often develop heart disease at younger ages than women, which is one reason many may associate heart disease with male gender. The risk of heart disease starts rising around age 45 for men, according to the Society for Cardiac Angiography and Interventions. Women, on the other hand, typically experience an increased risk about 10 years later—after menopause. The reason? The female hormone estrogen may help safeguard women’s hearts.
The exact link between estrogen and heart health isn’t fully understood, but scientists suspect that helps blood vessels remain flexible and better able to accommodate blood flow, according to the American Heart Association. This may explain why young and middle-age women have a lower risk of heart disease than men their age.
Following menopause—the time when women’s ovaries stop releasing eggs and monthly periods end—levels of the hormones estrogen and progesterone start to decline. At this time, the heart-health age gap between men and women starts to close.
THE EFFECT OF PREGNANCY
Menopause isn’t the only milestone that can impact a woman’s heart. Women’s overall well-being during pregnancy can also forecast future heart health.
Gestational diabetes and pre-eclampsia—a condition that causes high blood pressure during pregnancy—increase moms’ lifelong risk of heart disease. For example, women who’ve had pre-eclampsia are twice as likely to develop heart disease and may experience symptoms at younger ages, according to the National Heart, Lung, and Blood Institute.
GREATER IMPACT ON WOMEN
“Traditional” heart disease risk factors—such as carrying excess weight, diabetes, high blood pressure, and smoking—can affect both men and women, but some affect women more strongly. For example:
Diabetes. Women with diabetes are six times more likely to develop heart disease, while men with diabetes have just a two- to three-times higher risk, according to the American Diabetes Association. One possible reason: Women with diabetes are also more likely to have other related conditions, including obesity and high blood pressure.
Smoking. Go Red for Women reports that women who smoke have a 25-percent higher risk of heart disease compared to male smokers.
Stress. The jury’s out on whether or not stress has a direct correlation with heart disease. However, adults who are chronically stressed or who have a mental health condition, such as depression or anxiety, may be more likely to turn to alcohol, cigarettes, or high-calorie comfort foods, and/or have trouble finding the motivation to exercise. This stress effect may be even more pronounced in women, according to Mayo Clinic.
Cholesterol and triglyceride levels. After menopause, women often have higher levels of “bad” low-density lipoprotein (LDL) cholesterol than men. This can be deadly when coupled with high triglyceride levels—these two factors raise a woman’s risk of dying from heart disease, according to Harvard Medical School.
HEART ATTACK SYMPTOMS
Women’s heart attack symptoms can be different than men’s, making heart attacks harder to spot in women. For example, the defining heart attack symptom in men is usually chest pain, and most people know to call 911 if they (or a loved one) experience gripping pain or discomfort in their chests. But people may be less likely to seek medical attention for severe fatigue or shortness of breath—two common heart attack symptoms in women.
While women can experience chest pain during a heart attack—it’s the most frequent heart attack warning for both men and women—not all women do. The only warning signs for some women may be fatigue and insomnia in the days or weeks leading up to a heart attack, or jaw pain, shortness of breath, and nausea and dizziness.
In some cases, women even confuse their heart attack symptoms with illnesses like the flu. For this reason, women who notice any potential heart attack symptoms should seek emergency medical care.