High blood pressure smoking and diabetes increase heart attack risk more in women than in men

8 November 2018        

Category: BHF Comment

A study released today in the BMJ reveals some risk factors have a greater impact on heart attack risk in women than they do in men.

Overall, men are at greater risk of heart attack than women, but several studies have suggested that certain risk factors have more of an impact on the risk in women than in men. To look more closely at this association, researchers at Oxford University looked at data on almost half a million people enrolled in the UK Biobank - a database of biological information from British adults. The 471,998 people had no history of cardiovascular disease, were aged 40 to 69 years and 56% of them were women.

woman clutching her chest as if in pain with area highlighted red

High blood pressure, diabetes and smoking increased the risk of a heart attack in both sexes but their impact was far greater in women. Smoking increased a woman's risk of a heart attack by 55% more than it increased the risk in a man, while high blood pressure increased a woman's risk of heart attack by an extra 83% relative to its effect in a man.

Type II diabetes had a 47% greater impact on the heart attack risk of a woman relative to a man, while type I diabetes had an almost three times greater impact in a woman. The authors believe that theirs is the first study to analyse both absolute and relative differences in heart attack risk between the sexes across a range of risk factors in a general population, but they emphasise that it is an observational study, so no firm conclusions can be drawn about cause and effect.

In the UK, women with diabetes are 15% less likely than men with diabetes to receive all recommended care processes, and may be less likely to achieve target values when treated for cardiovascular risk factors.

While the overall impact of smoking, high blood pressure and diabetes on heart attack risk decreased in both sexes with age, the greater risk these factors had on the risk of heart attack in women relative to their impact in men persisted.

"Rising prevalence of lifestyle-associated risk factors, coupled with the ageing population, is likely to result in women having a more similar overall rate of myocardial infarction to men than is the case at present, with a subsequent significant additional burden on society and health resources," the authors warn.

Our Associate Medical Director Professor Metin Avkiran, said:

  “Regardless of your sex, risk factors such as high blood pressure, smoking and diabetes increase the risk of a heart attack.  These findings should not distract from a concerted effort to better detect and manage risk factors that can be changed.

“It’s absolutely vital that everyone has equal access to the best advice and treatment regardless of age, gender or socioeconomic status. This is an important reminder that heart disease does not discriminate, so we must shift perceptions that it only affects men.”

Find out more about BHF research into women and heart disease