Certain risk factors more likely to lead to heart attack in women than in men

New research published in The BMJ has shown that women who smoke, have diabetes, or have high blood pressure face a higher risk of heart attack than men with the same conditions.

Researchers at Oxford University analysed data held in the UK Biobank database, looking at almost 500,000 40-69 year olds. Over a period of seven years, over 5000 people suffered their first heart attack – one in three of these were women. These particular conditions seem to have a greater impact on women only, and heart disease remains the biggest killer of women living in the UK.

Over a period of seven years, over 5000 people suffered their first heart attack – one in three of these were women

The study showed that while smoking doubles the risk of a heart attack in men, the likelihood of women who smoke suffering a heart attack increases to three times that of women who don’t.  Both type 1 and 2 diabetes increased the risk of heart attack in women compared to men, and women with high blood pressure have on average an 83% higher chance of suffering from an attack than a man with the same condition.

Although the researchers aren’t sure why these conditions affect women more than men, they did suggest some biological and social factors that might explain this. They contend that one reason for the difference could be a difference in biology, e.g. that type 2 diabetes, normally related to poor diet and lifestyle, could affect the female heart in a different way than the male heart.

While smoking doubles the risk of a heart attack in men, the likelihood of women who smoke suffering a heart attack increases to three times that of women who don’t

It was also identified that women might be less likely to realise that they are at risk of heart disease – Dr Elizabeth Millett, lead author of the study, highlighted that: “Women need to be aware they’re at risk, but despite lots of campaigns, it’s still under the radar for most women.” Another suggestion was that doctors might be delivering worse care and treatment to women.

Whilst men are still three times more likely to have a heart attack than women, Dr Millett says that in the future, the rate of female heart attacks could increase to match that of male heart attacks. To prevent this, the researchers urge that for women with diabetes or high blood pressure, or for those who smoke, the risk level for a heart attack should be considered comparable with that for men. Doctors need to become more effective at recognising ‘at risk’ female patients. Women might also experience a heart attack differently to men, such as not suffering any chest pain, and better awareness of this difference is needed.