Cardiovascular disease and heart attacks: Differences in men and women

21 November 2022 dot 6-minute read
Healthy Body Feature Live Well Cardiovascular disease Illnesses and diseases Cardiovascular system
Moderate exercise can help lower the risks of heart attack and stroke. (Credit: Getty Images)
Some heart attacks can strike suddenly, with intensity, but most build slowly with mild pain. Symptoms of cardiovascular disease (CVD) – a group of disorders that affect the heart and blood vessels – can differ between genders, which is why getting a proper diagnosis is important. The good news is most disorders of the cardiovascular system are preventable.

Heart attack symptoms: Men vs women

Despite the long-held myth that heart attacks affect men more often, women are just as likely to experience them. CVD is responsible for 35 per cent of deaths in women globally each year, according to the latest figures from The Lancet.
According to the American Heart Association, "Women face a 20 per cent increased risk of developing heart failure or dying within five years after their first severe heart attack compared with men." This is partly due to a lack of awareness regarding the specific risk factors, signs and symptoms of their gender.
While men typically report chest pressure and some or all the typical signs of a heart attack, it's a different story for the opposite gender. Women are much more likely to be asymptomatic or experience atypical symptoms.
Warning signs in women are challenging to detect. This makes a heart attack diagnosis more complex. As a result, these signs often go unrecognised. They sometimes end up being dismissed or mistaken for symptoms of other non-life-threatening, non-heart-related conditions, such as acid reflux, flu, stress and anxiety.
The following symptoms – reported mainly by women – are worth noting:
New or severe fatigue
Feeling unusually tired after simple activities is a potential warning sign. If you're worn out after making the bed, taking a brisk walk or completing your regular exercise routine, something might not be quite right.
Lightheadedness and dizziness
Feeling like you might pass out when you try to stand up is not a normal sensation and shouldn't be ignored, especially when paired with one of the other signs.
Shortness of breath or sweating
This shortness of breath worsens when lying down and is relieved when you sit up. It can also occur without exertion or physical effort and may accompany chest pain and fatigue.
Pain in the neck, back or jaw
When the discomfort in these areas worsens upon exertion and stops when you are inert, it may be a cause for concern. Look out for pain that starts in the chest and spreads to the back and between the shoulder blades. Do the same for pain in the lower-left side of the jaw and either arm. Additionally, take note of sudden pain that wakes you up at night.

Heart size and function in men and women

Warning signs of a heart attack can appear hours, days or weeks in advance. Early detection can save your life. (Credit: Getty Images)
What makes the symptoms of CVD – the leading cause of death globally – look and feel different in men and women? The answers may lie in anatomy and physiology.
A woman's heart is smaller in size than a man's. Some of the interior chambers in a woman's heart can be smaller, too.
A woman's heart pumps faster than a man's but ejects less blood (approximately 10 per cent less, according to experts) with each pump. This usually changes under stressful conditions. For example, when a woman's pulse rate rises, it pumps more blood throughout the body, whereas a man's arteries constrict, reducing blood flow and raising blood pressure.
When it comes to coronary artery disease, men typically have plaque build-up (fatty deposits) in the largest arteries that supply blood to the heart. Women are more likely to develop plaque in the small heart arteries, known as the microvasculature. This can make diagnosis and treatment more challenging.

Cardiovascular disease risk factors

Elevated blood pressure is a causal risk of cardiovascular disease. (Credit: Getty Images)
Men and women share many risk factors for CVD, such as:
  • high blood pressure
  • high blood sugar levels
  • high cholesterol
  • obesity
  • diabetes
  • family history and genetic predisposition
  • smoking
  • metabolic syndrome (the co-existence of high blood pressure, obesity and high glucose)
  • high levels of C-reactive protein (a sign of inflammatory disease that can occur along with other cardiovascular risk factors)
But recent studies show women have unique risk factors.
  • Women with polycystic ovary disease (PCOS), endometriosis, gestational diabetes and pre-eclampsia (high blood pressure that develops during pregnancy) can be significantly at risk of coronary artery disease.
  • Stress and depression, more common among women than men, can also impact heart health and lead to complications.
  • Autoimmune diseases such as rheumatoid arthritis, which damages the blood cells through inflammation and can lead to plaque build-up, have been linked to an increased risk of CVD.
  • Research shows that relatively high testosterone levels increase hypertension before and during menopause, potentially leading to coronary artery disease or other cardiovascular disorders.

Lower your risk of cardiovascular disease

Although men have a higher risk of developing cardiovascular disease, women have higher mortality after acute cardiovascular events. (Credit: Getty Images)
Experts agree that simple lifestyle changes can significantly prevent cardiovascular disease and keep it from worsening or reversing some damage. Lower heart risk with these simple tips.
  • Maintain your body's ideal weight.
  • Quit smoking.
  • Eat a healthy diet of fruits, vegetables, whole grains and lean protein.
  • Watch your salt and added sugar intake. Avoid processed food that triggers or worsens inflammation, such as wheat, sugar and processed meat.
  • Avoid or limit alcohol consumption.
  • Look after your mental health. Tai Chi, yoga or meditation are great options to ease stress and anxiety.
  • Stay physically active and exercise regularly. Aim for at least 30 minutes of cardio activity twice a week.
Finally, consult your primary care physician about the risks and lifestyle changes you may need. You may also want to explore critical illness insurance with coverage for cardiovascular disease. AIA Absolute Critical Cover, for example, has a policy covering 187 critical illnesses, age-related illnesses and chronic diseases, including coronary artery disease, heart attack and stroke. It can help minimise the financial impact should you fall ill in the future and give you the peace of mind to focus on what matters most at present.
NIH. National Library of Medicine. 2017. Cardiovascular Disease in Women: Clinical Perspectives. [online] [Accessed on 16 June 2022]
American Heart Association. 2020. Women found to be at higher risk for heart failure and heart attack death than men. [online] [Accessed on 25 August 2022]
NIH. National Library of Medicine. 2017. Ten things to know about ten cardiovascular disease risk factors – 2022. [online] [Accessed on 16 June 2022]
WHO. World Health Organization. 2021. Cardiovascular Diseases (CVDs). [online] [Accessed on 16 June 2022]
American Heart Association. 2015. Heart attack symptoms in women. [online] [Accessed on 16 June 2022]

This is general information only and is not intended as financial, medical, health, nutritional or other advice. You should obtain professional advice from a financial adviser, or medical or health practitioner in relation to your own personal circumstances.

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