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Women’s heart health demands unique attention
The medical community oversimplified cardiac care for too long: A heart was a heart, regardless of whether it beat in a man or a woman.
Embedded in decades of research and clinical practice, this male-centric perspective has had profound, often tragic, consequences for women’s heart health, Northwell Health reports. Itâs time to fully acknowledge and act upon the critical differences that define the female cardiovascular system.
Historically, heart disease research has predominantly focused on men
From the 1940s through the 1970s, the vast majority of studies identifying heart disease risk factors and developing treatment strategies included only male participants. The assumption was that findings from men could simply be applied to women. This oversight meant that women’s unique physiological responses, symptoms, and disease presentations were largely ignored. While the Framingham Heart Study did include women, its early, limited data wrongly suggested that women didn’t really get heart disease, further hindering progress.
The true cost of this historical blindness became terrifyingly clear in the mid-1980s. As advanced treatments like stents and statins began to significantly lower heart disease mortality rates for men, women’s rates remained stagnant. Then, shockingly, they started to climb. More women than men were dying of heart disease for the first time, and the gap continued to widen. This undeniable disparity was the ultimate wake-up call, forcing us to ask: “Does biological sex matter?”
Women’s heart attack symptoms can differ and may be less obvious
The classic “Hollywood heart attack”âcrushing chest pain radiating down the armâis often a male presentation. Women, however, frequently experience chest pain, along with more subtle symptoms, such as shortness of breath, nausea, fatigue, or discomfort in the jaw, back, or arm. In the past, these were termed “atypical” symptoms and were too often dismissed, leading to delayed diagnosis, misdiagnosis, or even being told “it’s all in your head.” We also learned of “silent MIs,” where heart damage is seen on an ECG even without the woman experiencing overt symptoms.
Many women experience heart attacks without traditional coronary artery blockages
Historically, heart attacks were equated with completely blocked coronary arteries. Yet large, international studies like TIMI IIIB revealed that a significant percentageâup to a quarterâof women diagnosed with myocardial infarction had no obstructive lesions in their major arteries. This groundbreaking discovery challenged the very definition of a heart attack and showed that diagnostic gold standards were insufficient for women. It pointed to different underlying mechanisms of disease, such as microvascular dysfunction, a form of non-obstructive heart disease in which tiny coronary arteries fail to properly widen, reducing oxygen-rich blood flow to the heart muscle.
Risk factors and disease mechanisms often impact women uniquely
We now understand that biological sex influences cardiovascular health in myriad ways. Women with diabetes, for instance, have a markedly different risk factor profile than men with the same condition. Women are two to three times more likely to experience migraine with aura, a known risk factor for ischemic stroke. Even the most common mechanisms of sudden cardiac death differ between sexes, and women face a significantly higher mortality risk from certain chronic conditions.
The question has evolved from “Does biological sex matter?” to “How does it matter?” This must become the foundational principle guiding all future research, clinical practice, and medical education. It means asking how sex hormones impact cellular function, how to better include women in clinical trials, and how to tailor prevention, diagnosis, and treatment based on sex-specific differences.
This isn’t just about scientific curiosity; it’s about saving lives. Men should be more than allies; they need to be advocates, and even accomplices, in this crucial mission, recognizing that when we truly understand and address womenâs unique health, we elevate care for both men and women. Every woman deserves the most precise, gender- and sex-specific care modern medicine can offer.
This story was produced by Northwell Health and reviewed and distributed by Stacker.
