Heart Disease: Men vs. Women
By Julia Fiorentino, M.D.

Cardiovascular disease, which includes heart attack and stroke, is the leading cause of death among women and men. Although it is often thought of as a disease of men, more women than men actually die each year from cardiovascular disease.

Before the age of 55, men have a greater risk of heart disease than women. Since certain female hormones help protect the heart, women are less likely to die from this disease in the prime of their lives. After menopause, the risk for women dramatically rises, quickly equals, and ultimately surpasses the risk for men.

One mutual risk factor for heart attack and stroke is high blood pressure. Men have a greater risk until age 55. From that point until age 75, the risks are fairly equal for both genders; beyond age 75, women have a higher risk of high blood pressure.

Diabetes and high cholesterol are important risk factors for cardiovascular disease that are fairly equal among the sexes. These diseases are strongly associated with lifestyle choices (such as lack of exercise, poor diet, obesity/elevated BMI) but also have significant genetic tendencies.

Metabolic syndrome, a combination of fat around your abdomen, high blood pressure, high blood sugar, and high triglycerides, has a greater impact on women than men.

Smoking greatly increases the risk for heart disease in both genders, but it may be worse for women because it alters hormone levels and causes a greater inflammatory reaction. The risk is especially high for smokers who take birth control pills or estrogen replacement therapy. It is important to remember that it is never too late to quit. Even if you have smoked all your life, quitting will help decrease your risk.

Mental stress and depression affect women's hearts more than men's.

Symptoms of a heart attack are often atypical in women and can lead to misdiagnosis. For example, women are more likely to experience a heart attack without chest pain or have other conditions that mask their symptoms. They may also have vague symptoms such as fatigue, trouble sleeping, difficulty breathing, indigestion, or anxiety.

Heart attacks in women are often more severe. Women have a higher risk for complications or death, and women who do recover from a heart attack are more likely than men to have another.

Dr. Julia Fiorentino is a board-certified internist who takes special interest in women's health, adolescent health, and preventive medicine. For more information, please call 330-433-1555.