An newly published study in Nature suggests that half of women who suffer from heart failure are not treated properly due to the heart failure not being caused by a heart attack.
“Men and women have different biologies and this results in different types of the same heart diseases,” says Professor Eva Gerdts, of the Department of Clinical Science at the University of Bergen, said in a press release. “It is about time to recognize these differences.”
Her research team compared how common risk factors for heart disease affect men and women differently, noting in the their paper that “the predominance of common types of cardiometabolic disorders such as heart failure, atrial fibrillation and ischemic heart disease is sex specific, and our identification of these and the underlying mechanisms is only just emerging.” The team focused specifically on measures of obesity, high blood pressure, and diabetes. They continued by noting that new evidence suggests sex-specific processes at work, including sex-specific molecular mechanisms and hormones, that affect these risk factors.
A press release accompanying the study indicated that according to the World Health Organization, 11% of women and 15% of men are obese (with a body mass index above 30 kg/m2). Obesity, the authors pointed out, also increases the risk for diabetes, and women with diabetes tend to have worse outcomes than men with diabetes.
“If we see this from a life span perspective, we can see that obesity increases with age, and that this trend is greater for women than men,” Prof. Gerdts explained. “Obesity increases the risk of having high blood pressure by a factor of three. This, in turn, increases the risk of heart disease.”
In addition, the presence of estrogen also plays a role in the development of heart disase in women that differs from men. According to the authors, estrogen prevents the formation of connective tissue within the heart (the buildup of which makes the heart have to work harder to pump), which is the opposite of what happens in men. This is an advantage that disappears after menopause, and arteries then stiffer and more susceptible to disease. In men under 60, hypertension is the most common, and in persons over 60, women are most commonly experiencing hypertension.
Women also tend to smoke more than men (sometimes to control appetite or weight), which was also listed as a risk factor that increases blood pressure and elevates risk following menopause.
A comprehensive review of the important sex differences in cardiometabolic diseaseshttps://t.co/MSfTBhOCXG@NatureMedicine by Eva Gerdts @medofak_uib @uibglobal and @VZagrosek @ChariteBerlin @berlinnovation https://t.co/T707NnXsmt #womenshealth pic.twitter.com/Qz8y4StOj3
— Eric Topol (@EricTopol) November 7, 2019
— Professor M Z Khalil (@mzkhalil) January 7, 2020