High blood pressure, smoking and diabetes increase the risk of a heart attack in a woman, depending on how these factors increase the risk of a person, according to a new study published in the BMJ.
The rate of heart attacks in men remains three times higher than for women, according to Elizabeth Millett, an epidemiologist at the George Institute for Global Health at Oxford University. The study, however, found that these three factors – smoking, diabetes and high blood pressure – are more likely to be associated with a heart attack in women, indicating that more effort is needed to raise women's awareness of heart disease.
Millett's work is part of a wider bank of studies on gender differences in non-communicable diseases, George Institute.
"It strengthens the need for people to remember how they look at women and men while studying heart disease," Millett said.
Because her recent work is an observational study that fails to explain the causes, Millett has stressed the need for further research on why this gender difference exists.
Nearly half a million Britons who were enrolled in the UK Biobank were surveyed. They were aged between 40 and 69 and were recruited from 2006 to 2010. They were watched on average for seven years by the Millett team. Of the 471,998 participants, no cardiovascular disease was recorded in the past. Researchers found that during the study, 5,081 of these people had the first heart attack, of which 28.8% were women.
High blood pressure was a major factor; increased the risk of a heart attack by 83% more than in humans. Smoking caused a 55% more risk of heart attack, while Type 2 diabetes – associated with poor diet – had a 47% greater impact on heart attacks in women than in men.
The study identified some risk factors that affect women more than men. The Millett study examined the impact of three such risk factors and found that their disproportionate impact on women persisted at an age.
Deaths in heart attacks are lower for women than for younger age groups, according to a survey, and a previous survey showed that women experienced their first heart attack 9 years later than men on average.
Combined with the aging population, it is likely to be seen as "women catching up with men" in terms of the rate of heart attack, Millett explained. This would cause "another significant additional burden on society and health resources," the authors of the study said.
The study has some limitations. The UK Biobank project is mainly made up of white participants, making it more difficult to generalize knowledge to other groups. Millett also said that the surveyed had a slightly higher socio-economic status than the others in the United Kingdom.
"Notwithstanding your sex, risk factors such as high blood pressure, smoking, and diabetes increase the risk of heart attack, and these findings should not divert attention from a focused effort to better detect and manage risk factors that could be changed," he wrote e-mail Professor Metin Avkiran, Associate Medical Director of the British Heart Foundation.
According to the British Heart Foundation, each year around 188,000 hospital visits are due to a heart attack. Every year approximately 735,000 Americans have a heart attack, according to the US Centers for Disease Control and Prevention.
"We want women to be more aware that heart attacks occur in both women and men," says Millett. He believes that women have insufficient awareness of heart disease because men are more affected.
The study also emphasizes the need for doctors to be careful when their women are older, smoke, have diabetes or have high blood pressure. Physicians must ensure that women and men have equal access to health care programs to address these conditions, scientists said.
Millett added that consciousness is essential because the symptoms of heart attack may vary between men and women. Several symptoms – such as unusual tiredness, dizziness or cold sweating – are more common in women than in men, she explained.
"It is absolutely essential that everyone has the same access to the best advice and treatment regardless of age, gender or socio-economic status," Avkiran wrote. "This is an important reminder that heart disease does not differentiate, so we have to shift the perception that it only affects men."