Heart Disease in Women & Men: Can You Spot the Differences?

Kelly Epps, MD, is an interventional cardiologist at the Inova Heart and Vascular Institute. She is board-certified in interventional cardiology, cardiovascular disease and internal medicine and has a clinical interest in preventative care and women’s heart health.

Behnam Tehrani, MD, is an interventional cardiologist at the Inova Heart and Vascular Institute. He is board-certified in interventional cardiology, cardiovascular disease and internal medicine.

Heart disease has traditionally been viewed as a man’s disease. The reality is, heart disease affects just as many women as men. It’s the number one cause of death for both sexes every year in the United States.

Although the statistics are similar, the symptoms and risk factors of heart disease can look different in women than they do in men. Understanding those differences can help keep your heart healthy.

Heart Attack Symptoms: Women vs. Men

While heart disease can strike both men and women, heart attacks are more likely to occur in men — and tend to occur at younger ages than they do in women. After menopause, the risk for women increases. The average age for a first heart attack is 65 in men, compared to 72 in women. Still, women can certainly suffer a heart attack at any age.

Women who experience heart attacks tend to have longer hospital stays and more complications than the average male patient. Women are also more likely than men to die within the first year after a heart attack. Early recognition of heart attack symptoms can be life-saving.

Signs of heart attack in both men and women include:

• Chest pain or pressure
• Upper body pain or discomfort (including the arm(s), neck, back, or jaw)
• Sweating
• Subtle symptoms such as shortness of breath, weakness, nausea, lightheadedness or fatigue

Chest pain is the most common sign of a heart attack in both sexes. Yet women are more likely than men to report the less common signs. They are also more likely than men to experience subtle symptoms such as anxiety and sleep problems up to a month before the heart attack.

Risk Factors for Heart Disease

Certain factors increase the risk for heart disease in both men and women. Some of the most significant risk factors are:

• High blood pressure
• High cholesterol
• Smoking
• Family history of heart disease (especially in men before age 55 or women before age 65)

In women, there are some unique risk factors to be aware of. Women who have had pregnancy complications such as preeclampsia or gestational diabetes have an increased risk of heart disease, even many years later. Treatments for breast cancer such as chemotherapy and radiation therapy can also increase risk of heart disease. Certain autoimmune diseases such as rheumatoid arthritis and lupus increase risk as well. While many of these diseases affect both sexes, they are more prevalent in women.

Heart Disease Prevention

Male or female, if you’re at increased risk of heart disease, it’s especially important to engage in healthy behaviors. Heart-healthy choices include getting regular exercise, eating a nutritious diet and controlling blood pressure and cholesterol levels.

To prevent and manage heart disease, it’s so important to establish regular care with a knowledgeable doctor. Your physician can check your heart health and help you manage risk factors with medications or lifestyle changes.

And those management strategies make a difference. Over the last few decades, we’ve seen death rates from heart disease drop in both men and women. That’s partly due to new medications and treatment guidelines, and also due to increased awareness.

Still, we need to do more to make sure people understand the risks posed by heart diseases, especially to women. According to surveys by the American Heart Association, most women incorrectly believe cancer kills more women than heart disease.

Inova is a champion of personalized medicine for patients with heart disease. A patient’s sex is just one factor we consider as we work with patients to diagnose and manage heart conditions.

Visit the Inova Heart and Vascular Institute to learn more about our award-winning team of heart specialists. Or listen to our podcast, “Inova Ask The Doctor: How Heart Disease Differs for Men and Women,” to hear more from Dr. Epps and Dr. Tehrani.