- A new study reveals lifestyle factors like diet, exercise, and smoking have a greater impact on women’s heart health than men’s.
- Women with poor health face nearly five times the risk of heart disease compared to women with ideal health, while men face 2.5 times the risk.
- Researchers suggest sex-specific screening and risk assessment could improve heart disease prevention and motivate healthier habits.
- There are evolutionary biological differences between men and women.
- The nurturer could be more impacted by environmental and dietary stressors.
- The provider could be more adapted to handle those same environmental and dietary stressors.
Women’s health: a double-edged sword
Heart disease, long considered a leading cause of death worldwide, may not affect men and women equally. A groundbreaking study presented at the American College of Cardiology's Annual Scientific Session reveals that lifestyle and health factors linked to heart disease have a more pronounced impact on women than men. The findings challenge the traditional one-size-fits-all approach to cardiovascular risk assessment and suggest that tailored strategies could better address the unique needs of each sex.
The study, led by Maneesh Sud, MD, PhD, of Sunnybrook Health Sciences Centre in Toronto, analyzed data from over 175,000 Canadian adults enrolled in the Ontario Health Study between 2009 and 2017. None of the participants had heart disease at the start of the study, and about 60% were women. Researchers focused on eight key factors associated with heart disease: diet, sleep, physical activity, smoking, body mass index, blood glucose, lipids, and blood pressure.
Biological and evolutionary insights
The results showed that women were more likely to have ideal health profiles compared to men. For instance, 9.1% of women scored a perfect 8 out of 8 on the risk factor scale, compared to just 4.8% of men. Women also had better outcomes in individual factors like diet, blood glucose, cholesterol, and blood pressure. However, when women did have poor health profiles, the consequences were far more severe.
Women with poor health faced nearly five times the risk of heart disease compared to women with ideal health, while men with poor health faced 2.5 times the risk. Similarly, women with intermediate health had 2.3 times the risk of heart disease compared to their ideal-health counterparts, while men with intermediate health had 1.6 times the risk.
“We found that women tend to have better health than men, but the impact on outcomes is different,” Sud said. “The combination of these factors has a bigger impact in women than it does in men.”
The study’s findings align with the evolutionary roles of men and women. Men, historically tasked with defending and protecting their families, may be biologically hardwired to adapt to environmental stressors like physical exertion and exposure to danger. Women, on the other hand, are more biologically attuned to nurturing and emotional sensitivity, which may make them more susceptible to the effects of lifestyle choices like diet and exercise.
This evolutionary perspective underscores the importance of recognizing biological differences in heart health. For women, lifestyle decisions may carry greater weight due to their unique physiological and emotional wiring. As Sud noted, “For the same level of health, our study shows that the increase in risk [related to each factor] is higher in women than in men—it’s not one-size-fits-all.”
A call for tailored approaches
The study’s findings highlight the need for sex-specific screening and risk assessment tools. Current approaches often treat men and women as interchangeable, but this research suggests that a more nuanced strategy could yield better outcomes. For example, women might benefit from more aggressive interventions targeting diet and exercise, while men might require different approaches to address environmental and stress-related factors. Heart-related stress in men could be exacerbated by their stoicism, by holding things in, by their inability to express emotions and rid their minds and bodies of stress. Heart-related stress in women could be more greatly impacted by sensitivities to their environment - their bodies not being provided what they need.
The researchers also plan to explore how these risk factors impact different racial and ethnic groups, as well as women before and after menopause. These additional analyses could provide even deeper insights into the complex interplay between biology, lifestyle, and heart health.
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