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Heart Attack In Men vs Women: Who Is At Greater Risk?

Written by Reshma Pathare on Fri, 09 December 2022 — Fact checked by Dr. Pramod Mane

Key Highlights

  • Research suggests that men are twice more likely to have a heart attack, as compared to women.
  • 70-90% of sudden heart attacks are experienced by men; the likelihood is lesser in women
  • However, women are five times more likely than men to suffer from MINOCA i.e., non-obstructive heart attacks
  • Men who bottle up their negative emotions without giving them an outlet, are five times more likely to suffer a heart attack
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A commonly-seen phenomenon, heart attack is a cardiac problem wherein oxygen-rich blood flow to the heart gets severely reduced or completely stopped.  
Heart attack is an ailment that may creep up with no warning signs, or may show very mild symptoms intermittently, that may not give a chance to the person to realize if they’re facing an imminent heart attack.  
Hence, it is best to keep a close watch on the signals that the body gives and immediately consult a doctor if some red-flags begin showing up more than once, even if they are mild in nature.

Heart attack symptoms

One of the foremost warning signs of an impending heart attack is mild pain in the chest area after doing some work or exercise with not too much exertion (stable angina).  
Sometimes, these pains are experienced even while resting (unstable angina). Anginal pains tend to subside in a few minutes, but never ignore them if they start coming recurrently. Those are the first symptoms of a heart attack

Apart from that, some common warning signs of heart attack include:

  • Shortness of breath, irrespective of not doing much exertion. This may or may not be accompanied by anginal pains.
  • Shooting pains in one or both arms or shoulders
  • Pain in the jaw, neck or back
  • Breaking into a cold sweat, irrespective of the weather
  • Having clammy, sweaty palms or feeling numbness in palms
  • Feeling suddenly dizzy or lightheaded
  • Feeling nauseous or getting a sensation of vomiting
  • Suffering from heartburn, indigestion, or abdominal pain
  • Having persistent, phlegmy cough

Heart attack symptoms in men vs women

It is pertinent to note that myocardial infarction symptoms in males and females may be somewhat different.  
While some symptoms like shortness of breath and pain in jaw/arms/back may be common to both, women have more chances of having a MI without feeling any chest pains.  
Women are also more likely to display less-obvious symptoms like sleep disturbances, nausea, dizziness, and indigestion that are not immediately, directly attributable to heart attack.  
In fact, the less-obvious symptoms that women show are more connected with regular lifestyle disturbances such as anxiety or acid reflux.

What are the common risk factors of heart attack? 

There are several obvious and non-obvious risk factors that can lead to heart attacks. The risk factors start showing effect faster in men than women, due to reasons that’ll be discussed ahead.

common risk factors of heart attack

The common risk factors for heart attacks include:

  • Gender: Being a male makes you more prone to getting a heart attack at an earlier age than women 
    Obesity: Having a BMI more than 25 makes a person overweight, and a BMI above 30 makes them obese. Both these factors – especially, obesity – can be directly causative for heart attacks because it leads to increase in blood pressure, increase in levels of bad cholesterol, and sets the stage for diabetes that leads to inflammation.
  • Visceral fat deposits: Having excessive belly fat can lead to high blood pressure, high blood sugar, high lipid levels, and inflammation – all increasing the risk for heart attacks.
  • Exposure to smoke: Being exposed to nicotine via active or passive smoking leads to less oxygen supply to the heart, hardening of the arterial walls, narrowing of arteries, and chronic inflammation. 
  • Exposure to pollution: Breathing polluted air filled with harmful particulate matter as emanated from industrial smoke; exposure to mining activities that lead to breathing in of lead, arsenic, cadmium; and exposure to smoke from household activities that involve biomass fuel are all seen to increase the risk of various heart ailments, including heart attacks.
  • Diabetes: Diabetes leads to excessive blood sugar which destroys the nerves and blood vessels responsible for controlling and supporting the heart. People with diabetes also suffer from high blood pressure, which makes the heart work harder to do its functions, and also builds up plaque in the arteries.
  • Metabolic syndrome: When a person suffers from high blood sugar, high BP, excessive visceral fat, and high levels of bad cholesterol, they’re said to be suffering from metabolic syndrome, which makes them twice more prone to getting heart attack than others. 
  • Heredity: Having a history of heart attack in the family makes you genetically prone to having one
  • Sedentary lifestyle: Lack of physical activity increases obesity and blood pressure, thus becoming causative for heart attack
  • Stress: Chronic stress can cause high BP, formation of blood clots, and inflammation that leads to heart attack
  • Autoimmune disorder: People suffering from any autoimmune disorder such as lupus, or RA, are at risk for inflammation that causes heart attack 

Why is it that mostly men get heart attacks and not women? 

It is interesting to note that while both men and women have a heart, there are specific gender differences in the way they get prone to heart attacks, and the way their body reacts to it.  

Research has shown that men are more likely to get a heart attack, especially a sudden one, than women.  
The risk factors affect both genders. In fact, women have an added risk of increased heart rate and possible pre-eclampsia during pregnancy which increases the risk of heart problems like CAD and strokes two times over. 

Heredity, obesity, diabetes, autoimmune disorders all affect both genders the same vis-à-vis heart attacks. 
Yet, women remain protected from heart attacks (for that matter, most cardiac ailments) by the magical hormone ‘oestrogen’, till they reach menopause and the hormone starts drying out. 

Thus, the possibility of heart attacks gets postponed by 7-10 years on an average in women, as compared to men. However, ironically, it remains a major cause of death in women beyond 65.

How does oestrogen help keep a woman safer from heart attacks?

Well, for starters, oestrogen has a good influence on metabolic factors like inflammatory markers, lipids, and coagulants in the body. It also helps the alpha and beta receptors in the walls of blood vessels to enhance the blood flow (vasodilation effect). 

As menopause starts setting in, the oestrogen levels start dipping gradually, which in turn changes the atherosclerotic plaque composition to lesions having inflammatory factors. This starts making women increasingly vulnerable to heart attacks than before.

In contrast, high testosterone and low oestrogen levels in men make them more prone to heart attacks at a younger age. High testosterone contributes to a build-up of bad cholesterol, whereas, low oestrogen builds up high blood sugar levels – both risk factors for heart attacks. 

Another important factor to consider is the way men and women react to stress and related negative emotions like anxiety and depression. While such emotions are common to both, women tend to externalise their stress faster and better than men. Men instead tend to internalise the stress, which in turn keeps pressurising their immune system further more.  

Of course, it is not the rule of thumb; individual natures also play a role in the way people react to stress. But on an average, a higher number of men tend to internalise their stress, compared to women who are quicker to find an outlet via crying or indulging in therapeutic pursuits like painting or yoga. 

Chronic stress is known to increase the levels of plaque, inflammation, and blood pressure – all contributory factors to a heart attack. According to a Swedish study, men who bottle up negative emotions are five times more likely to suffer from a heart attack. 

A pertinent factor to be considered here is that these probabilities change form in case of women who are smokers or have an endogenous oestrogen deficiency. Such women can suffer from heart attacks even in younger ages.  

Smoking increases the risk of the first MI more in women than in men. So also, women with diabetes are at increased risk of MI, as compared to diabetic men of the same age.  
Nevertheless, these are exceptions. On a whole, men tend to be prone to heart attacks more and earlier than women.

The tables turn: Death rate from heart attacks in men vs women

On the backdrop of the information seen above, it may come as a surprise that when it comes to the male vs female death rate due to heart attacks, it is women who tend to die more than men from heart attacks.  
There are several factors presumed to be responsible for this fact.

Death rate from heart attacks in men vs women

  • Firstly, since women are usually older (beyond 60s) when they go into the heart-attack-vulnerable bracket, the sheer ageing of the body makes it difficult for them to recover faster. 
    Secondly, women tend to show little and less prominent symptoms of an impending heart attack as compared to men. While men usually feel a crushing pain in the chest, women tend to feel little or no pressure before a heart attack happens. 
  • Rather, women tend to show symptoms like nausea, fatigue, and acid reflux which tend to get attributed to lifestyle factors than an inherent heart problem. This results in late or missing diagnosis, thus making the attack fatal for women.
  • Even when it comes to diagnosis, an angiogram may not be able to show blockages lurking in the coronary arteries, because, in women, these blockages happen more in smaller arteries which are difficult to see in the angiogram. In men, the blockages happen in the more prominent big arteries. 
  • Another factor for women succumbing to heart attacks more than men is that women tend to put on more fat than muscle, which when coupled with unhealthy eating habits or genetic disposition, can give them more bad cholesterol and blood pressure than a man.
  • Also, women have a slower metabolism than men, which makes it difficult for them to lose weight, thus complicating the journey.
  • Menopause also makes women start gaining more visceral fat, which in itself is a fatal risk factor for heart attacks.

Conclusion

Suffice to say, both men and women are equally vulnerable to getting a heart attack. Just that men are prone faster and at a younger age than women, but women can get more severely affected to the problem than men. 

In both cases, diagnosis at the earliest and subsequent treatment is the key to having a healthy heart. 

Heart attack treatment options include lifestyle management, medications, or surgery. The earlier you get diagnosed, the easier it is to manage your heart health with least invasive options like lifestyle management. 

Keep evaluating your vulnerability to the common risk factors at different stages of life. If you’re hereditarily predisposed to heart attack, then this evaluation should begin as early as your 30s.  

Keep away from avoidable risk factors like excessive smoking, unhealthy diet, and a sedentary lifestyle.  

Most of all, do not shun even minor warning signs, if they keep showing up more often. It may just be your body cautioning you of a heart attack. 

Listen to what your body is trying to tell, and it’ll keep you healthy for long.

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Reshma Pathare

Reshma Kulkarni-Pathare has been a self-employed media professional since 1999. Starting off as a Freelance Journalist for Times of India Thane Plus, Reshma went onto write for more than 45 national and international publications including Times of India, New Woman, Femina, Indian Express, The Hindu, BBC Good Homes and many more. While her forte has been lifestyle writing, she is equally proficient in writing health articles. Her health articles have been published in Health International (Dubai), New Woman, Femina, and Mother & Baby.

Apart from being a journalist, Reshma also works as a copy-editor for self-publishing houses and academic journals.

She is an award-winning bi-lingual translator with more than 12 books published in her name.

She has been a Visiting Faculty Member for post-graduate department of mass media at MET College (Mumbai) and Welingkar WeSchool (Mumbai).

She has worked as a Consumer Marketing Insights Researcher for global organizations like CEB Iconoculture (USA) and Gartner (USA).

Consolidating her multifarious skills in the media, in 2021, Reshma launched her own boutique media agency called Talking Turkey Communications, which specializes in content writing, editing, and translation.

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  1. American Heart Association - About Heart Attacks 
    Cleveland Clinic - Can You Have a Heart Attack Without Having Any Blocked Arteries?
  2. American Heart Association - Uncommon heart attack, found more often in women, needs a second look
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    The Sydney Morning Herald - Internalising work stress deadly
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  7. Mayo Clinic - Menopause weight gain: Stop the middle age spread
  8. Science Daily - Men's heart disease risk linked to high testosterone and low estrogen