Smoking, diabetes, high blood pressure: all bad for the heart, but perhaps worse for women's hearts than men's, new research shows.
Looking at data on 472 000 Britons ages 40 to 69, researchers found that all three of these heart disease risk factors increased the odds of heart attack for both sexes.
Heart disease not 'men only'
But the rise in risk went even higher for women than men.
For example, while male smokers had more than twice the risk of heart attack than men who had never smoked, women smokers had more than three times the risk of heart attack than those who had never smoked, the study found.
The same trend held for high blood pressure and diabetes, according to the team led by Elizabeth Millett of the University of Oxford. High blood pressure was tied to a more than 80% higher risk for heart attack risk in women than in men; type 1 diabetes was associated with an almost three times higher risk in women than in men; and type 2 diabetes with a 47% higher risk in women than in men.
One risk factor – overweight or obesity – was associated with similar increases in heart attack risk in women and men, the researchers reported in The BMJ.
"Overall, more men experience heart attacks than women," Millett, an epidemiologist at Oxford's George Institute for Global Health, said in a university news release. "However, several major risk factors increase the risk in women more than they increase the risk in men, so women with these factors experience a relative disadvantage."
Importance of universal screening
Two cardiologists in the United States said the findings highlight that heart disease is certainly not a "males-only" disease.
"What makes this study important, is that over half of the studied population was female – most cardiovascular studies have a male majority," noted Dr Satjit Bhursri, who practices at Lenox Hill Hospital in New York City.
"It is also true that women are less likely to get similar screen and prevention interventions than men," he said. "This study brings to light the importance that screening for cardiovascular disease is universal, as are the outcomes."
Dr Cindy Grines directs cardiology at Long Island Jewish Medical Center in New Hyde Park, New York. She stressed that heart disease remains the number one killer of American women, especially as the natural cardio-protective effects of oestrogen fades after menopause.
What the new study "means is that traditional risk factors such as high blood pressure, smoking and diabetes need to be addressed as soon as possible," even before menopause, Grines said.
"These findings highlight the importance of raising awareness around the risk of heart attack women face, and ensuring that women as well as men have access to guideline-based treatments for diabetes and high blood pressure, and to resources to help them stop smoking," she said.
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