Heart Disease Risk in Women: A Silent Threat Revealed
For decades, heart disease has been perceived as a “man’s disease.” But groundbreaking research published today in Circulation: Cardiovascular Imaging challenges that notion, revealing that women may face significant heart risks even with lower levels of artery plaque than men. This finding has major implications for how we diagnose and treat heart disease in women, potentially saving countless lives.
The Plaque Paradox: Why Women Are Different
Traditionally, doctors have assessed heart disease risk based on the amount of plaque buildup in arteries. However, this new study, involving over 4,200 adults, demonstrates that this metric may be misleading when it comes to women. Researchers found that women experienced heart attack and chest pain with a lower plaque burden, and their risk increased more rapidly than men’s, particularly after menopause.
“Our findings underscore that women are not ‘protected’ from coronary events despite having lower plaque volumes,” explains Dr. Borek Foldyna of Harvard Medical School, the study’s senior author. “Because women have smaller coronary arteries, a small amount of plaque can have a bigger impact. Moderate increases in plaque burden appear to have disproportionate risk in women, suggesting that standard definitions of high risk may underestimate risk in women.”
Understanding the Disparity: Smaller Arteries, Bigger Impact
The key lies in the anatomy of women’s cardiovascular systems. Women generally have smaller coronary arteries than men. This means that even a relatively small amount of plaque can significantly narrow these arteries, restricting blood flow and increasing the risk of a heart attack or chest pain. The study showed women’s risk began to rise at just 20% plaque burden, while men’s risk didn’t start to increase until 28%.
Beyond Plaque: The Role of Microvascular Disease
While this study focused on plaque buildup in major arteries, experts emphasize that other factors contribute to heart disease in women. Microvascular disease, affecting the tiny blood vessels in the heart, is more common in women and often goes undetected by traditional tests. This condition can cause chest pain and shortness of breath, even without significant plaque buildup.
According to research published in JACC Cardiovascular Imaging, women often present with less calcified lesions and a higher prevalence of microvascular disease compared to men, highlighting the need for a more nuanced approach to diagnosis.
The Future of Cardiovascular Imaging for Women
This research underscores the urgent need for improved diagnostic tools and treatment strategies tailored to women’s unique cardiovascular profiles. Future trends in cardiovascular imaging are likely to focus on:
- Advanced Imaging Techniques: Moving beyond traditional angiography to incorporate techniques like cardiac MRI and PET scans to assess both plaque burden and microvascular function.
- Personalized Risk Assessment: Developing risk scores that account for factors like age, menopause status, and family history, in addition to plaque levels.
- AI-Powered Diagnostics: Utilizing artificial intelligence to analyze imaging data and identify subtle signs of heart disease that might be missed by the human eye.
- Hormonal Considerations: Further research into the impact of hormonal changes, particularly during and after menopause, on cardiovascular risk.
“There is an overdue recognition of fundamental, biological differences in the way health conditions manifest in women vs. Men,” says Dr. Stacey Rosen, President of the American Heart Association. “These differences can influence everything from risk factors to symptoms to treatment response.”
Did you recognize?
Cardiovascular disease is the leading cause of death for women in the United States, accounting for 47.3% of all female deaths in 2026, according to the American Heart Association.
FAQ: Heart Disease in Women
- Q: Are heart attack symptoms different in women?
A: Yes, women are more likely to experience symptoms like shortness of breath, nausea, and back or jaw pain, rather than the classic chest pain often associated with heart attacks in men. - Q: Should women be screened for heart disease earlier?
A: Discuss your risk factors with your doctor to determine the appropriate screening schedule. Early detection is crucial. - Q: What can women do to reduce their risk?
A: Maintain a healthy lifestyle, including a balanced diet, regular exercise, and stress management. Manage existing conditions like high blood pressure and diabetes.
Learn more about heart health at heart.org.
For Media Inquiries: Bridgette McNeill at [email protected] or 214-706-1173.
