Why women’s risk for CVD spikes later in life

Research out of Norway suggests obesity, high blood pressure and diabetes could have a lot to do with CVD’s tendency to present later in life in women than in men. 

Writing in a paper published in Nature Medicine, Eva Gerdts, of the University of Bergen, and colleague Vera Regitz-Zagrosek said that as many as 50% of women who suffer from cardiac arrest are treated insufficiently because their heart attack wasn’t the result of an MI. The other half of women with heart disease can attribute the condition to untreated high BP that grew more aggressive over time.

“Men and women have different biologies and this results in different types of the same heart diseases,” Gerdts said in a release. “It is about time to recognize these differences. Medically speaking, we still do not know what the best treatment for heart attack or failure is in many women. It is an unacceptable situation.”

Gerdts and Regitz-Zagrosek pinpointed a number of factors that could contribute to women’s increased risk of CVD over time, one of them being obesity. Obesity has been shown to increase with age, and it’s well-established that that trend is more apparent in women than in men. Obesity also hikes a woman’s risk of type 2 diabetes, which is linked to unhealthy fat storage in the heart and a resulting higher risk of CV disease.

The authors described an “estrogen advantage” with women that dissipates after menopause, leaving them with stiffer arteries and high blood pressure. Estrogen prevents the formation of connective tissue in the heart, and obese men store the hormone in their fat cells in the abdomen, which Gerdts said “has a bad effect on the heart.”

“For persons under 60, high blood pressure is most common amongst men,” she said. “For persons over 60, it is the opposite. We think that this is part of the explanation for why high blood pressure seems to indicate higher risk of heart disease amongst women.”

Gerdts and Regitz-Zagrosek said women are also prone to start smoking later in life than men, typically as a means to reduce their appetite and control their weight. It’s just one of the risk factors that increases after menopause, leaving women more vulnerable to CVD later in life.