Edited by Kate Findley and proofread by Angela Shoemaker, The Great Courses Daily
Is it true that men are at a higher risk for heart disease than women? Not necessarily. Professor Anding addresses risk factors for heart disease—some you might not be aware of.
Heart Disease and Age
Non-modifiable risk factors for heart disease are things that we can’t change, such as our age. Some statistics suggest that even individuals who have normal blood pressure at age 55 can develop high blood pressure in their lifetime.
Aging is often associated with an increase in blood lipids, glucose intolerance, metabolic syndrome, and diabetes. After age 35 in men and age 45 in women, the probability of dying of cardiovascular disease increases.
“That’s not all gloom and doom because there’s so much that we can do to prevent that,” Professor Anding said. “Lifestyle modification is effective at reducing some of the health risks associated with aging.”
Risk Factors by Gender
Gender is another non-modifiable risk factor. Due to heavy media attention on cardiovascular disease in men, men are actually improving in terms of early identification and treatment. However, women often have a higher risk of death because symptoms go undiagnosed or untreated, and they tend to have more lethal or more severe first-time heart attacks.
Women typically believe that heart disease is a man’s disease, and they’ll do everything within their power to take care of their sons, husband, and other men in the family, but they may be reluctant to seek care for chest pains themselves. They may ignore symptoms of chest pains, and often the symptoms are slightly different in women.
Some studies also suggest that these symptoms in women are often attributed to other things such as anxiety or stress. In general, more women are fearful of breast cancer than heart disease. Statistically, though, women are more likely to develop heart disease in their lifetime than breast cancer.
The National Nurses Study reported that the incidence of heart disease decreased by about 20% over the study period from 1980 to 1994. Somewhere in the range of 80% to 90% of nurses are female.
Smoking cessation was thought to contribute to about 13% of the decline in heart disease, and improvement in diet represented about 16%. These percentages are not necessarily additive, but they provide more evidence to suggest that making a change at any time of your life can decrease your likelihood of developing heart disease.
The key finding is that heart disease is an equal opportunity killer for men and women. Women just generally have their heart disease expressed slightly later than men.
Women with diabetes have an even higher risk. Some estimates suggest that diabetes increases the risk of heart disease by five.
Other Risk Factors
Polycystic ovarian syndrome (PCOS) is thought to be an insulin-resistant disease. Often women with PCOS have few periods and problems with fertility.
They can actually have some expression of too much testosterone, so they can end up with facial hair, male pattern baldness, and a male distribution in body fat. Some of this is driven by estrogen, and some is driven by the imbalance between estrogen and testosterone.
The pattern of coronary artery disease blockage differs between men and women. Men tend to have more isolated blockage and women have a more scattered blockage pattern that occupies longer portions of the vessel. Thus, although it impacts men and women equally, it isn’t expressed the same way clinically.
“So I think the tragedy is if you have diabetes, you often ignore those warning signs,” Professor Anding said. “If you have PCOS, you’re not connecting infertility with heart disease, but there is a connection there.”
Therefore, it’s important to recognize that conditions often do not occur in isolation but are interrelated. You can reduce your risk for heart disease by getting regular checkups, eating a healthy diet, and engaging in regular exercise.
This article was edited by Kate Findley, Writer for The Great Courses Daily, and proofread by Angela Shoemaker, Proofreader and Copy Editor for The Great Courses Daily.
Professor Roberta H. Anding is a registered dietitian and Director of Sports Nutrition and a clinical dietitian at Baylor College of Medicine and Texas Children’s Hospital. She also teaches and lectures in the Baylor College of Medicine’s Department of Pediatrics, Section of Adolescent Medicine and Sports Medicine, and in the Department of Kinesiology at Rice University.