Gender, rather than sex, is more closely linked to risk for heart attack in young adults, according to a landmark study recently published in the Journal of the American College of Cardiology.
This study was conducted in response to growing concerns about the unique impact that sex and gender have on health. As defined in a 2001 report by the Institute of Medicine, gender reflects social norms for men and women, while sex defines biological characteristics. However, the unique roles of gender versus sex have generally been neglected in clinical research in recent decades.
That’s why researchers recently looked at the impact of both sex and gender on risk for acute coronary syndrome. Acute coronary syndrome (ACS) is an umbrella term used to describe situations where there is sudden, reduced blood flow to the heart. ACS encompasses heart attack and unstable angina (chest pain) and as past research suggests, may affect women and men differently. The question, however, is whether gender or sex is the driving force behind disparities.
To learn more, researchers analyzed data from the GENSIS-PRAXY study, which included 909 young patients hospitalized for ACS in centers across Canada, the United States and Switzerland. Patients were between 18–55 years old and followed for a year after hospitalization.
During the study, patients completed questionnaires about four key characteristics related to gender—gender roles, gender identity, gender relationships and what is termed “institutionalized gender.” Together, these characteristics include how individuals perceive and present themselves, unspoken cultural rules that influence attitudes and behaviors, and power relations between individuals with different gender identities.
What researchers found is that feminine roles and personality traits were associated with higher rates of chest pain, heart attack and heart-related death. So men and women with more feminine characteristics were more likely to have heart events, regardless of their sex. Patients with more masculine traits had lower risk for heart events, regardless of whether they were biologically male or female. Interestingly, there was no significant association between sex and key heart outcomes.
Based on findings, authors conclude that feminine qualities increase cardiovascular risk in young adults with ACS, regardless of sex. Researchers believe that higher levels of anxiety may be to blame for this association, although more research is needed on the topic.
Findings also highlight the need to distinguish between gender and sex in medical research. Until now, most research has looked at differences in outcomes between men and women. However, it’s clear that gender and sex are not the same, and as this study shows, have unique impacts on health.