Last updated on Jun 23rd, 2021 at 02:53 pm

Traditionally, women and men have been treated for heart disease in the same way. Factors contributing to a higher risk of heart disease were considered common between both genders

However, according to Dr Leslie Cho, a Cleveland Clinic cardiologist who led a team tasked with updating recommendations on women and cardiovascular diseases for the American College of Cardiology, there are biological factors that put women at higher risk of developing heart disease.

Pregnancy-related conditions

Pregnancy-related conditions have not always been considered as having a long term impact on heart health.

Dr Cho’s research shows that women who have high blood pressure during pregnancy, gestational diabetes, preterm birth and miscarriages all increase a woman’s risk of developing heart disease. Dr Cho says this discovery means women who are at high risk can be identified at a younger age and preventative measures can be taken.


Oestrogen, a hormone that is found in higher concentrations in women, is widely known to offer women protection from heart disease. However, when oestrogen levels drop (as they do naturally during menopause), Dr Cho says a woman’s risk of heart disease increases, especially in the case of premature menopause (menopause before the age of 40).

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“Oestrogen offers women some protection from heart disease until after menopause when oestrogen levels drop. This is why the average age of for a heart attack in women is later, at 70, as opposed to 66 in men,” says Dr Cho.

Related: Cope better with menopause 

PCOS and endometriosis

Another sex-specific risk factor is a hormonal condition called polycystic ovarian syndrome (POCS), found in one in 10 women. This is associated with cardiometabolic factors, which, in turn, are associated with increased heart disease risk. The cardiometabolic factors associated with POCS include abdominal obesity, abnormal glucose control and diabetes, elevated blood pressure, and abnormal amounts of fats – such as cholesterol – in the blood, known as dyslipidemia.

“Endometriosis, has also been found to raise the risk of developing coronary artery disease – the leading cause of heart attacks – by 400% in women under age 40,” says Dr Cho.

Women are at greater risk of illnesses related to heart disease

Regarding sex-related differences in the traditional risk-factor category, it has been found that hypertension and diabetes are strong risk factors in women. Another risk factor, high blood pressure, is more common in women over the age of 50 than in men.

Woman are also more likely than men to experience depression or mental health issues, such as anxiety and chronic emotional stress, that can have an impact on their heart health.

“We really should be treating not just the blood pressure number, or the cholesterol number, but rather treating the whole patient, including their mental health, to have a good cardiovascular outcome,” says Dr Cho.

She adds that studies have also shown sex differences in response to treatments, and doctors need to take these into account.

Source: Cleveland Clinic

Cleveland Clinic is a non-profit multispecialty academic medical centre that integrates clinical and hospital care with research and education.

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