Heart Disease Risk: Women vs. Men
UW Health Services
When it comes to heart disease, factors that may explain the apparent disparity in treatment of men and women include:
- In the past, many of the major cardiovascular research studies were conducted on men. Results of clinical studies under way may help clarify gender differences that may affect diagnosis and treatment of women with heart disease.
- Clinicians and patients often attribute chest pains in women to non-cardiac causes, leading to misinterpretation of their condition.
- The most common warning sign of a heart attack in both men and women is chest discomfort – most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
Women, however, are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain. This may not be accompanied by typical chest pain. Women are also more likely to report unexplained fatigue.
- Women may avoid or delay seeking medical care, perhaps out of denial or not being aware of both typical and atypical heart attack symptoms.
- Since women tend to have heart attacks later in life than men do, they often have other diseases (such as arthritis or osteoporosis) that can mask heart attack symptoms. Increased age and the more advanced stage of coronary heart disease in women can affect treatment options available to physicians. Increased age also can help explain women's greater mortality after heart attacks.
- Some diagnostic tests and procedures may not be as accurate in women, so physicians may avoid using them. That means the disease process resulting in a heart attack or stroke may not be detected in women until later, with more serious consequences.
- The exercise stress test, or stress ECG, may be less accurate in women. For example, in young women with a low likelihood of coronary heart disease, an exercise stress test may give a false positive result. In contrast, single-vessel heart disease, which is more common in women than in men, may not be picked up on a routine exercise stress test.
- More precise noninvasive and less invasive diagnostic tests tend to cost more. These include thallium, sestamibi or echocardiographic stress tests.