A recent study presented at the American College of Cardiology's Annual Scientific Session has revealed that lifestyle and health factors associated with heart disease have a greater impact on cardiovascular risk in women than in men.
While diet, exercise, smoking, and blood pressure have long been recognized as key contributors to heart disease, this study is the first to demonstrate that these risk factors have a stronger correlation with cardiovascular risk in women compared to men.
Researchers suggest that implementing sex-specific screening and risk assessment strategies could offer a more accurate understanding of cardiovascular risk, thereby encouraging individuals to adopt heart-healthy lifestyles.
According to Maneesh Sud, MD, PhD, assistant professor in the department of medicine, interventional cardiologist, and clinician scientist at Sunnybrook Health Sciences Centre in Toronto, "For the same level of health, our study shows that the increase in risk [related to each factor] is higher in women than in men--it's not one-size-fits-all. This is novel and something that hasn't been seen in other studies."
The study analyzed eight key factors related to heart disease: diet, sleep, physical activity, smoking, body mass index, blood glucose, lipids, and blood pressure. Overall, the findings indicated that women were more likely to exhibit positive health factors compared to men. However, women with negative risk factors experienced a greater increase in their chances of suffering from a heart attack, stroke, or other cardiovascular events than men with a similar health profile.
"We found that women tend to have better health than men, but the impact on outcomes is different," Sud explained. "The combination of these factors has a bigger impact in women than it does in men."
The study examined data from over 175,000 Canadian adults who participated in the Ontario Health Study between 2009 and 2017. At the start of the study, none of the participants had heart disease, and approximately 60% of them were women. Researchers categorized each participant's health profile based on the eight risk factors, classifying them as ideal, intermediate, or poor.
Over a median follow-up period of just over 11 years, researchers monitored participants for seven major heart disease outcomes, including heart attack, stroke, unstable angina, peripheral arterial disease, heart failure, coronary revascularization, and cardiovascular-related death.
The results showed that significantly more women were classified as having ideal health, with 9.1% of women and 4.8% of men scoring a perfect 8 out of 8. Women were also less likely to be categorized as having poor health, with 21.9% of women and 30.5% of men falling into this category. In terms of individual risk factors, women were more likely to have an ideal diet, blood glucose, cholesterol, and blood pressure but were slightly less likely than men to achieve ideal physical activity levels.
After adjusting for age, researchers found that both men and women with poor or intermediate health had a higher risk of heart disease than those with ideal health. However, the disparities were more pronounced in women. Women with poor health had nearly five times the risk of heart disease compared to women with ideal health, while men with poor health had 2.5 times the risk compared to men with ideal health. Additionally, women with intermediate health had 2.3 times the risk of heart disease compared to their ideal-health counterparts, while men with intermediate health had 1.6 times the risk.
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