Gender gap in heart disease outcomes narrows

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Introduction

Disparities in heart disease outcomes between men and women are reducing over time, according to a recent study from Intermountain Health researchers.¹

Heart disease presents in approximately 45% of women aged over 20 years, making it the leading cause of mortality along this population. The new data reveals that while rates remain high among women, the prevalence of cardiac events is narrowing between the sexes.

“The reality is that women are different from men and need to be evaluated, diagnosed, and treated differently for heart disease,” said Kismet Rasmusson, NP, principal investigator and nurse practitioner at Intermountain Health. “While these findings show that we’ve made progress… we still have a long way to go.”

Study overview and methodology

The study included 14,248 women and 26,524 men visiting Intermountain for coronary angiography from 2000 to 2019. Using X-rays and contrast dye, a coronary angiography can visualize the coronary arteries. These provide blood to the heart, indicating an increased risk of heart attack when blocked.

Data was obtained from electronic health records. Based on this information, investigators found increased odds of smoking, prior heart attack, left ventricular dysfunction, and hyperlipidemia in men treated for heart disease vs their female counterparts.

In comparison, women presented with more comorbidities such as diabetes, high blood pressure, and prior stroke or heart failure. Additionally, they had more stable chest pain and less severe chest pain or heart attack when presenting at the catheterization laboratory vs their male counterparts.

The data also indicated reduced blockage in the arteries and heart in women, alongside less revascularization by 60 days, while coronary artery bypass graft was more frequent in men. Cardiac medication prescriptions were also given to women less than men, despite these medications being proven to influence outcomes.

Long-term outcomes and mortality

Overall, women had a significantly increased prevalence of experiencing a major cardiac event within 1 or 3 years compared to men. In large part, this was linked to increased mortality rates among women. However, these differences narrowed over time when breaking the 19-year period into periods of 5 years.

In the 2015 to 2019 period, no significant differences in major cardiac event rates were reported between women and men. Rasmusson highlighted how the data indicates unique risk factors in women, supporting data from prior studies.

Limitations and the need for risk management

Investigators noted that national trends may not correlate with those identified in the study, as patients from only a single health system were included. However, awareness toward heart disease risk has been declining over time, from 65% in 2009 to 44% in 2019. A study published in the journal Circulation confirmed this trend, highlighting awareness in under half of participating women.

The increase in impact from heart disease factors among women vs men has been proven in previous studies. A study presented at the American College of Cardiology’s Annual Scientific Session found a 5-fold increased risk of heart disease among women with poor or intermediate health factors vs their male counterparts, along with a 2.5-fold increase among those with ideal health.²

“Women need to know their risk of heart disease is equal to that of men, and is the leading cause of death, more so than all cancers combined,” said Rasmusson.¹ “Women need help to manage their risk factors, recognize cardiac symptoms, and seek prompt care – this will make a difference.”

References

1. Study finds gap between heart disease outcomes in men and women has narrowed over past 20 years. Intermountain Healthcare. March 31, 2025. Accessed March 28, 2025. https://www.eurekalert.org/news-releases/1078411?
2. Krewson C. Study finds greater impact of heart disease risk factors in women vs men. Contemporary OB/GYN. March 20, 2025. Accessed March 28, 2025. https://www.contemporaryobgyn.net/view/study-finds-greater-impact-of-heart-disease-risk-factors-in-women-vs-men.