The Role of Gender in Heart Disease

mom-daughter-gran (1)Every minute in the United States, someone’s wife, mother, daughter or sister dies from heart disease, stroke or another form of cardiovascular disease (CVD) Heart disease is the No. 1 killer of women, and is more deadly than all forms of cancer combined. Heart disease causes 1 in 3 women’s deaths each year, killing approximately one woman every minute.

An estimated 43 million women in the U.S. are affected by heart disease. While 1 in 31 American women dies from breast cancer each year, 1 in 3 dies of heart disease. (AHA Go Red statistics)

For years, heart disease was thought of as a “man’s disease,” but more women than men die of heart disease each year. Since 1984, more women than men have died each year from heart disease and the gap between men and women’s survival continues to widen. Despite increased awareness over the past decade, only 54% of women recognize that heart disease is their number 1 killer [2].


Heart disease is the No. 1 killer in women. Yet, only 1 in 5 American women believe that heart disease is her greatest health threat. Ninety percent of women have one or more risk factors for developing heart disease.

The largest risk factors of heart disease affect both men and women. The good news is that many of the major contributing factors can be controlled, including:

  • Hypertension (high blood pressure)
  • Tobacco use
  • Raised blood glucose (diabetes)
  • Physical inactivity
  • Unhealthy diet
  • Cholesterol/lipids
  • Overweight and obesity
  • Metabolic syndrome
  • Mental stress and depression
  • Pregnancy complications such as high blood pressure or diabetes during pregnancy

There are also other risk factors that are not modifiable such as age and family history. Although men and women share a lot of the same risks, your gender can play a role in heart disease. Some risks that vary by gender are the following:

  • Age – men tend to develop coronary artery disease earlier in life. However, after age 65 the risk of heart disease in women is almost the same as in men.
  • Women, especially younger women (<65 yrs), have worse outcome after a heart attack.
  • Diabetes is a particularly important risk factor for developing heart disease in women. The symptoms of heart disease in diabetic women can be very subtle. Women may have mild heartburn or breathlessness during physical exertion rather than chest pain that is considered typical in men or in people without diabetes.
  • Unhealthy behaviors – Men tend to engage in certain high-risk behaviors that can have adverse effects on the heart, such as tobacco use and alcohol consumption. 20.5% of adult men smoke cigarettes compared to 15.3% of women, putting men at a higher risk [3]. Similarly, studies have shown that high-volume drinking is consistently more prevalent among men than among women [4].


The most common symptoms of heart attack in women is some type of pressure, discomfort or pain, in the chest. However, sometimes, women may have a heart attack without chest pains. Women are more likely than men to have heart attack symptoms unrelated to chest pain, such as:

  • Neck, jaw, shoulder, upper back or abdominal discomfort
  • Shortness of breath
  • Right arm pain
  • Nausea or vomiting
  • Sweating
  • Lightheadedness or dizziness
  • Unusual fatigue

These symptoms can be more subtle, like pressure or tightness, than the crushing chest pain often associated with heart attacks in men. Women’s symptoms may be triggered by mental stress and may occur more often when women are resting, or even when they’re asleep.

About the Author

parashar-susmitaSusmita Parashar, MD, MPH, MS, FAHA, FACC is a Board certified cardiologist at the Emory Heart and Vascular Center and Associate Professor of Medicine (Cardiology) at Emory University School of Medicine. Dr. Parashar is an educator and cardiovascular outcomes researcher with emphasis on women and heart disease, preventive cardiology and heart disease in cancer patients. She has received several grants and awards from the National Institute of Health (NIH) and the American Heart Association (AHA) to conduct research on women and heart disease. Dr. Parashar was awarded the AHA Trudy Bush Fellowship for Cardiovascular Research in Women’s Health Award to recognize outstanding work in the area of women’s health and cardiovascular disease


[1] – Heart Disease Facts
American Heart Association – 2015 Heart Disease and Stroke Update, compiled by AHA, CDC, NIH and other governmental sources

[2] – Women and Heart Disease Fact Sheet.

[3] Center for Disease Control (CDC). “Current Cigarette Smoking Among Adults in the United States.”

[4] Wisnack et al. “Gender and Alcohol Consumption: Patterns From the Multinational Genacis Project.”
Addiction. 2009 Sep; 104(9): 1487–1500.

[5] – Men and Heart Disease Fact Sheet.

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