Heart disease is the leading cause of death for both men and women, according to the Centers for Disease Control and Prevention. But while this disease is deadly for both sexes, how and when heart attacks occur can vary greatly — leading to differences in care.
While younger men are more likely to experience heart attacks than younger women, women quickly catch up as they age.
“Up to age 55, men are more prone to have heart disease,” says Dr. Mrugesh Soni, a cardiologist at TPMG Heart and Vascular Center in Newport News, Va., “but after age 55, women are more likely to get heart disease. Most people always think that men are more prone to heart disease.”
The cause of this age difference in heart disease is unclear, but may have to do with menopause, Soni says. The leading theory is that estrogen, a female hormone, helps protect women from heart disease while they are younger. However, during and after menopause, women’s estrogen levels drop, leading to more heart disease. More research is needed to determine if this theory is true.
No matter the cause, it’s vital that women know that heart disease, not cancer, is the leading cause of death in women. According to an American Heart Association (AHA) survey, only about 56 percent of women know this fact, which may affect when they seek care.
Newer research, meanwhile, also suggests that heart attacks are becoming more common in younger people, especially women.
Cardiovascular research has historically not focused on those under 55, according to the heart association. But a study presented to the AHA in 2018 showed that heart attacks among young women were going up. The numbers seem to correlate with rising rates of obesity, diabetes and hypertension in young women. Cardiologists say the research shows how important it is to pay attention to symptoms at any age, no matter the gender.
Signs and Symptoms
Men and women can have very different heart attack symptoms, even when they experience the same types of heart attacks.
“Typically, men get left-sided or mid-chest pain that feels like pressure or squeezing,” says Soni. “The pain may radiate to the left arm or left jaw. But women have a variety of symptoms.”
Women may or may not have any chest pain during a heart attack. Instead, they may have symptoms such as:
- Shortness of breath
- Pain in the upper part of the stomach
- Pain in the shoulder or back
- Jaw or neck pain
- Nausea and vomiting
It’s still not clear why these symptoms are different, but it’s important for women to be able to identify heart attack symptoms as quickly as possible.
Timing of Emergency Care
Because of the wide variety of atypical symptoms and the stereotype that heart attacks are more of a men’s problem, women may receive care for heart attacks later than men. While men may recognize chest pain as a heart attack right away, women may spend hours vomiting or feeling in pain before going to the emergency room.
“Women usually come late to the emergency room,” Soni says. “It’s not like they don’t want to show up, but they have an atypical presentation. They think it is something that will get better on its own.”
This difference in seeking care matters because time is muscle during heart attacks. By the time women receive care, they may have more irreversible heart damage than men. According to the AHA, 26 percent of women over age 45 die within a year of their first heart attack, whereas only 19 percent of men over age 45 do.
Preventive care and screenings are the best way to reduce the risk of heart attacks — but Soni says that women are usually under-referred to cardiologists for signs of heart disease.
“Women are always undertreated because their presentation is atypical,” Soni says. “Women sometimes complain about symptoms to their primary care physician, but the doctor may think it gastrointestinal or psychiatric.”
Early evaluation is vital for both men and women, especially if they have symptoms such as angina (chest pain) or shortness of breath. Men and women should also seek out preventive care and screenings if they have:
- A parent or sibling who has had a heart event earlier than age 55 in men or age 65 in women
- High blood pressure
- High cholesterol
- High blood sugar
Smoking and lack of physical activity also increase the risk of heart attacks in both sexes.
“We cannot treat age or family history, but the other factors everyone has to work on,” Soni says. “Addressing those risk factors can cut down their chances of having a cardiac event.”
Whether you are a man or a woman, getting more exercise, eating well and working with your primary care physician to control other risk factors can help you improve your heart health and extend your life.
Dial, Don’t Drive During a Heart Attack
If you or a loved one are experiencing symptoms of a heart attack, it’s vital you get to the emergency room right away. But how you arrive matters. Call 911 and let an emergency medical crew come to you. Don’t try to drive to the hospital on your own or even have a family member bring you.
- Dialing 911 offers many benefits for you (and other drivers on the road), including:
- EMS can diagnose your heart attack and have a team ready for you at the nearest hospital, leading to faster care.
- If you experience an abnormal rhythm, EMS can shock your heart back into rhythm, possibly stopping sudden cardiac death.
- If you are driving yourself and experience an abnormal rhythm, you may faint and hit other drivers or pedestrians, harming yourself and others.
- You are likely to arrive at the hospital faster in an ambulance than you would in a private vehicle.
- Dialing 911 instead of driving to the hospital can save your life and the lives of others.
If you or someone around you is experiencing heart attack symptoms, call 911 immediately.