How Heart Disease is Different for Women

Heart disease prevention and treatment specific to women discussed in new report

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Heart disease is one of the biggest threats to women's health. Additionally, health problems affect men and women differently. A recent report looked at the differences between women's heart health and men's heart health

The researchers, who were cardiovascular doctors, based their conclusions on several studies involving women and heart disease.

They reported that some types of prevention, like aspirin, may not be as effective for women. Also, they presented previous research showing that women were more likely than men to develop certain heart conditions.

"Ask your doctor about appropriate heart disease prevention."

Sahar Naderi, MD, MHS, of the Heart and Vascular Institute, and Leslie Cho, MD, Director of the Women's Cardiovascular Center at Cleveland Clinic, wrote this report in order to spotlight prevention and treatment of heart disease in women.

Heart disease is the leading cause of death among women around the world. More women than men die of heart disease in the United States.

Additionally, the report claims that heart disease affects women differently than men — women have different symptoms and respond to treatments differently.

The authors of the report used aspirin as an example of treatments that may not work as well for women as they do for men. According to the report, women need to be aware of the differences in treatment effectiveness and possible side effects.

Aspirin has been recommended as a prevention strategy for heart disease. Several previous studies have shown that a regular dose of aspirin may reduce the risk of heart attack. However, the vast majority of participants in these studies were men.

The Women's Health Study included almost 40,000 women age 45 or older who received regular doses of aspirin or a placebo (fake medication) for 10 years. That study concluded that the women who received aspirin did not have a significant reduction in the risk of heart attack compared to women who did not take aspirin.

The Women's Health Study also showed that women who took aspirin had significantly more gastrointestinal bleeding. Yet, aspirin users in a subgroup of women over 65 years old had a significant reduction in the rate of heart attack.

"Given the risk of significant gastrointestinal bleeding and a trend toward hemorrhagic stroke with aspirin use, it is important to weigh the risks and benefits of aspirin for primary prevention in women," the report authors wrote.

The report also claims that women have different risk factors for heart health problems.

For example, the report references studies showing that women who take hormone therapy may be at an increased risk for developing heart disease. A combination of estrogen and progestin or estrogen alone can be used to treat menopause symptoms. These hormone therapies are also used to prevent osteoporosis, a bone disease that results in weaker, less dense bones, after menopause.

The report referenced a Women's Health Initiative study that showed that women who take estrogen and progestin may develop heart disease more than women who don't take those hormones. Some evidence suggests that starting hormone therapy later in life contributes to a greater risk of heart disease. However, extensive trials on the relationship between hormones and heart disease have not been conducted.

According to the report, women's symptoms are often different than men's, as well. Typical symptoms of heart problems include chest pain and discomfort brought on by stress, and they normally go away with rest or nitroglycerin.

One study analyzed in the report found that 9 percent more women than men reported atypical symptoms, including nausea and vomiting.

Lastly, the report emphasized that certain heart conditions affect mostly women, such as microvascular angina, a heart condition that affects the heart's smallest blood vessels; stress cardiomyopathy, or heart muscle weakness due to emotional or physical stress; and spontaneous coronary artery dissection, or a tear in a heart artery.

The authors of the report concluded that women respond better to certain types of prevention and treatment, and they also face different heart health problems than men.

The authors wrote that more research must be done to identify better prevention and treatment plans for women with heart problems. 

"More research is now being dedicated to identifying sex-specific aspects of cardiovascular disease, the better to prevent and treat it," they wrote.

This report was published in the Cleveland Clinic Journal of Medicine in September.

The authors did not disclose funding sources or conflicts of interest.

Review Date: 
September 5, 2013
Last Updated:
September 7, 2013