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When it comes to heart disease, men and women are not created equal. In whatever way you look at heart disease – the way it is best diagnosed, the symptoms, the risk factors that contribute to its progression, as well as treatments or their application – clear differences emerge based on whether you are born a woman or a man.

While efforts are underway to better understand these sex-specific differences in heart disease, today's research is just a start.

So, if you are a woman or care for one, listen up. Arming yourself with knowledge about your risk is important. Coronary heart disease is not just a "man's disease," and its effect on women tends to be riddled with misunderstandings. While deaths related to coronary artery disease – known as CAD for short – are declining overall, rates are increasing in young women.

To put it into context, more women have died from heart disease than all cancers combined. All told, heart disease claims the lives of 1 out of 3 women in the U.S. each year.

Coronary artery disease is the most common type of heart disease. It develops when your coronary arteries, which act like fuel lines to supply blood and oxygen to the heart, become damaged or diseased. This often results when plaque or atherosclerosis builds up in the walls of the arteries.

When your coronary arteries become narrowed or blocked, it limits blood flow to the heart. In some cases, the plaque can rupture, and blood flow is abruptly reduced and completely blocked. CAD can lead to:

  • Chest pain (angina)
  • Heart attack
  • Heart failure
  • Heart rhythm problems

In women more often than men, these things can occur even without evidence of any obstructive coronary artery disease. This may be because the small vessels of the arteries are not responding normally. This makes the diagnosis and treatment in women challenging.

Women are just as likely as men to develop CAD. Diabetes is the strongest risk factor in women. In fact, studies suggest diabetes more than triples the chance of CAD in women, compared with doubling the chance for men.

In women, CAD usually develops seven to 10 years later in life compared with men. Menopause seems to trigger a host of risk factors including:

  • Weight gain, especially carrying excess fat around your waist or midsection
  • Higher blood pressure
  • Unfavorable changes in cholesterol levels (rise in LDL and triglycerides, fall in HDL)

When women experience symptoms of a heart attack, women tend to:

  • Experience many other symptoms in addition to chest pain or chest pressure
  • Have no overt signs of blockages in the three major coronary arteries on tests, although blood flow to the heart muscle is reduced
  • Have diffuse blockages or vascular dysfunction in smaller arteries (men are more likely to have plaque buildup in the large arteries around the heart)
  • Be treated less aggressively with guideline-recommended therapies than men
  • Be less likely to dial 911 when they experience symptoms of a heart attack
  • Last Edited 03/11/2021