Does Gender Matter? Heart Health for Women vs. Men

For a long time, men have been the focus of heart health. However, heart disease affects an equal amount of men and women. Yet, all is not equal in heart health for the sexes. While the two share some risks and symptoms, men and women have very different factors affecting their heart health.

Path to improved health

There’s a lot going on inside the bodies of men and women. Here’s how heart health for women differs from men, and what women need to know about heart disease prevention, diagnosis, and treatment:

Physical differences:

  • Hormones affect men and women differently. For example, during a woman’s reproductive years, the hormone estrogen protects against heart disease. Changes in cholesterol levels can occur before menopause. During menopause, changes in cholesterol can increase a woman’s risk for heart disease. This is particularly true in women over age 65.
  • Diabetes is a serious disease for both men and women. However, it puts women at even greater risk of heart disease. On average, women develop heart disease a decade later than men. A woman with diabetes, however, loses that 10-year advantage. Diabetes, combined with obesity, high blood pressure, and high cholesterol further increases the risk. If you are a woman who has already had a heart attack and you have diabetes, your risk of a second heart attack is double than that of a woman who has had a heart attack and does not have diabetes.
  • For a woman, the greatest risk for heart disease is from having metabolic syndrome. Metabolic syndrome occurs when you have at least three of the following conditions: high blood pressure, glucose intolerance (pre-diabetes or diabetes), and high cholesterol. People with metabolic syndrome also typically have excess belly fat.
  • A woman’s heart is made up of smaller blood vessels than a man’s. This may be one reason they become blocked so easily and quickly.
  • Smoking is harmful to men and women. However, female smokers are twice as likely to have a heart attack as men who smoke.

Heart disease symptoms: women vs. men

  • Angina (chest pain) is common with heart disease. In men, chest pain feels like intense pressure and tends to go away with rest. In women, sometimes there is no chest pain. When there is, it often feels like a sharp, burning pain in women. Also, women often experience pain in their neck, jaw, throat, shoulder, abdomen (stomach), or back. It often occurs while a woman is resting or sleeping. Chest pain can also be triggered by mental or emotional stress in both men and women. Unfortunately, female chest pain is sometimes mistakenly diagnosed as a result of anxiety or depression instead of a sign of a heart attack. This is another reason it’s important for women to know the differences.
  • Chest pain is more likely to occur in women during low physical activity, such as shopping or cooking. In men, it is more likely to occur during heavy physical activity, such as exercise, athletics, or shoveling snow.
  • When having a heart attack, women are more likely to experience nausea, vomiting, extreme fatigue (overly tired), and problems breathing. Men are more likely to break out into a cold sweat and have a shooting pain down the left arm. Both sexes can experience lightheadedness or dizziness. Some women report having experienced indigestion, anxiety, and a racing heart a month before having a heart attack.

Both men and women share similar characteristics for heart failure and arrhythmia (the rate at which your heart beats). With heart failure, it’s common to experience shortness of breath and fatigue during physical activity. You also may experience swelling in your feet, ankles, legs, abdomen, and the veins in your neck.

With arrhythmia, both men and women report a fluttering or thumping with their heart. They also may feel as if their heart is skipping a beat (heart palpitations).

Things to consider

Bad habits can increase your risk of heart disease and heart attacks. This is true for both men and women. Lower your risks by taking these steps:

  • Stop smoking. Smoking damages the lining of your arteries. It can greatly increase your risk of developing cardiovascular diseases.
  • Get moving. Regular exercise can lower your blood pressure and help you maintain a healthy weight.
  • Eat a well-balanced, healthy, low-salt diet. Lean meats and fish, whole grains, vegetables, and fruits are heart-healthy food choices.
  • Lower your stress levels.
  • See your doctor if you are suffering from depression. Depression can take its toll on heart health.
  • Know and maintain your health metrics, including body mass index (BMI), waist circumference, total cholesterol, and blood pressure.

Questions to ask your doctor

  • Should men and women take a daily baby aspirin for good heart health?
  • Are there blood and imaging tests to screen for heart disease in both men and women?
  • If I have a family history of heart disease, does that increase my risk?
  • Can a traumatic event trigger a heart attack even if you have no evidence of heart disease?


Centers for Disease Control and Prevention, Heart Disease

Centers for Disease Control and Prevention, Women and Heart Disease Prevention

National Heart, Lung, and Blood Institute, What Are the Signs and Symptoms of Heart Disease?

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