Heart Disease: Difference in Men and Women

By Dr. Stanley Chia, Cardiologist, Mount Elizabeth Novena Hospital

Heart disease is unfortunately a common and devastating disease that affects millions of people worldwide each year. Although it is frequently considered an illness associated with middle-aged or older men, more women than men actually suffer from heart disease in many countries. This makes heart disease even more deadly than all cancers put together.

Photo credit: Sharon Sinclair on Flickr

A major challenge in diagnosing heart disease and especially coronary heart disease in women is that the warning signs in women may be different from those in men. Hence many women delay getting help for their heart problems.

Coronary heart disease is a condition when cholesterol plaque builds up in the walls of the coronary arteries, and blocks the flow of oxygen-rich blood to the heart. The most typical heart attack symptom is “crushing” chest pain – frequently described as chest tightness, heaviness, or “constriction” that may radiate to the jaws or arms. However, women do not always experience these classic symptoms and may even have a heart attack without chest pain at all. When heart attack strikes, women are more likely than men to experience atypical symptoms such as pain in the arms, back, neck, jaw or even stomach. The pain can be gradual or sudden, may wax and wane before becoming more intense and is often mistaken as heartburn, gastritis or muscle ache. Some women may complain of shortness of breath, nausea or lightheadedness at the time of heart attack. Other subtle symptoms include breaking out in cold sweats and feeling extremely tired while not doing any strenuous activities.

Photo credit: Aaron Boomfield on Flickr

Common risk factors for heart disease, such as high blood pressure, high blood cholesterol levels and obesity can affect all patients. However, certain risk factors may play a more significant role in the development of heart disease in women compared to men. Diabetes mellitus, metabolic syndrome, smoking, mental stress, depression and lack of physical activity all have a greater impact on the progression of cardiovascular disease in women.

Women are also at higher risk for other types of heart disease. Coronary microvascular disease is a condition that affects the heart’s tiny arteries, and may be caused by low levels of oestrogen after menopause. Patients may experience chest pain while they are resting or even sleeping as the symptoms may be triggered by mental stress. Women are also more likely to have a condition called “broken heart syndrome”, where extreme emotional stress can lead to heart muscle failure. In general, women tend to have heart disease 10 years later than men.

Photo credit: Kurman Communications, Inc. on Flickr

The good news is that heart disease is often preventable. Women can control many of the risk factors for heart disease through lifestyle changes and medication. They can lower the risk of heart attack by these important measures:

  1. Quitting, or not starting smoking
  2. Exercise regularly, at least 5 days a week, 30 minutes each time
  3. Maintain a healthy weight
  4. Have a sensible diet – low in animal saturated fat, low in salt
  5. Take the medication their doctors have prescribed, such as blood thinners (aspirin), blood pressure and cholesterol lowering medication, and diabetic medication if they have high blood glucose levels.

Most importantly, they must not ignore the warning signs of heart disease…

Listen to your body, and don’t dismiss what you feel.  Don’t worry about feeling silly if you’re wrong. It’s better to have it checked out!


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