Study finds greater impact of heart disease risk factors in women vs men

Study finds greater impact of heart disease risk factors in women vs men | Image Credit: © Ton Photographer4289 - © Ton Photographer4289 - stock.adobe.com.

Introduction

The impact of lifestyle and health factors on heart disease is more significant in women vs men, according to a recent study to be presented at the American College of Cardiology’s Annual Scientific Session.¹

Data has found associations of diet, exercise, smoking, and blood pressure with heart disease risk. However, this is the first study to note a more significant association in women compared to men.

““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,” said Maneesh Sud, MD, PhD, assistant professor in the department of medicine at Sunnybrook Health Sciences Centre and lead study author. “This is novel and… hasn’t been seen in other studies.”

Study population and methodology

Over 175,000 Canadian adults from the Ontario Health Study were included in the analysis. Data from 2009 to 2017 was collected, and 60% of participants were women. Heart disease was not present in any patients at baseline.

There were 8 risk factors assessed, with participants classified as having ideal or poor health for each one. An overall risk factor profile was obtained by combining these scores. Patients with under 5 positive factors or more than 3 negative scores were classified as poor, 5 to 7 positive factors as intermediate, and all 8 positive factors as ideal.

Follow-up lasted for a median 11 years. Heart disease outcomes reported during this time included heart attack, stroke, unstable angina, peripheral arterial disease, heart failure, coronary revascularization, and cardiovascular death. The incidences of these outcomes were reported for participants in each group.

Health outcomes

Ideal health was reported in 9.1% of women and 4.8% of men, indicating a higher rate among women. Additionally, women were less likely to report poor health, with rates of 21.9% and 30.5%, respectively.

The odds of having an ideal diet, blood glucose, cholesterol, and blood pressure were increased among women. However, men were more likely to have ideal physical activity levels.

Impacts in women vs men

An increased risk of heart disease was observed in both women and men who had poor or intermediate health vs ideal health. However, this association was stronger in women compared to men, with 5-fold and 2.5-fold increased risks, respectively, among those with poor vs ideal health. Among those with intermediate health, risks were increased 2.3-fold and 1.6-fold, respectively.

These results highlighted the increased effect of heart disease among women with associated lifestyle and health factors vs men. Investigators plan to conduct further research about how the impact of these risk factors may differ between racial and ethnic groups, as well as based on menopausal status.

“Further study is needed to understand how each factor might be affecting outcomes differently in men and women based on either biological or sociocultural factors,” wrote investigators.

Sex-specific heart disease risk

Alongside these risks, women also face sex-specific risks for heart disease compared to men.² These risks were discussed in a video interview with Contemporary OB/GYN by Martha Gulati, MD, professor of cardiology at Cedars Sinai.

According to Gulati, reproductive health factors unique to women are linked to heart disease risk. These include the age at which menstruation begins, adverse pregnancy outcomes, and early menopause. Gulati highlighted the need for collaboration between cardiologists and OB-GYNs to address these unique risks.

References

1. Lifestyle risks weigh heavier on women’s hearts. American College of Cardiology. March 18, 2025. Accessed March 20, 2025. https://www.eurekalert.org/news-releases/1077170.
2. Krewson C. Understanding cardiovascular risk factors in women. Contemporary OB/GYN. October 28, 2024. Accessed March 20, 2024. https://www.contemporaryobgyn.net/view/understanding-cardiovascular-risk-factors-in-women