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Johns Hopkins Health Alert

Research on Men, Women, and the Heart

When it comes to the heart, men and women are more different than you might think. Here are insights on men, women, and cardiovascular health from the world of research.

  • Standard Tool May Misjudge Women's Heart Risks

The first step doctors take to judge heart attack risk may underestimate the odds for many women, according to an article in the American Heart Journal (Volume 150, page 1276).

In a study of 102 healthy women with a family history of early heart disease, many who had evidence of atherosclerosis in their coronary arteries were nonetheless judged to be at low risk for a heart attack according to their Framingham risk score (a standard measure that doctors use to gauge the odds of suffering a heart attack in the next 10 years). It is based on age, blood pressure, cholesterol levels, and smoking habits.

In the study, 98% of the women were deemed low risk based on their Framingham score. Yet when the researchers took computed tomography (CT) scans of the women’s coronary arteries, they found that one third had enough calcium buildup to signal significant atherosclerosis for their age. Calcium is a component of the plaques that can clog arteries.

One of the problems with the Framingham score is that it does not take into account family history of premature heart disease. Thus, healthy women with a sibling with early heart disease may a heart CT scan to better gauge their heart health. If the CT scan reveals signs of advanced atherosclerosis for their age, these women might consider taking aspirin or a statin to help lower their heart attack risk.

  • Fitness Protects Men From Cluster of Heart Risks

Middle-aged men who stay fit may lower their odds of developing a collection of risk factors for heart disease, according to a study from Archives of Medical Research (Volume 37, page 522).

The researchers studied 449 men and found that those with the highest fitness levels were unlikely to have the metabolic syndrome, a cluster of heart risk factors that includes abdominal obesity, high blood pressure, elevated blood glucose (sugar) and triglycerides, and low HDL levels. The syndrome is diagnosed when a person has three or more of these factors.

In the study, only 6% of the men with the highest fitness levels met the criteria for the metabolic syndrome -- vs. one third of the least fit men. Half of the fittest study participants had none of the components of the metabolic syndrome, compared with only 18% of their out-of-shape counterparts. The study included middle-aged men (average age 47) who were free of any heart disease symptoms. Participants walked on a treadmill to gauge their fitness levels and underwent an evaluation for their heart risk factors.

Overall, men with the lowest fitness levels were nearly 12 times more likely than their fit peers to have the metabolic syndrome. These findings point to the importance of even modest increases in regular, brisk physical activity, which could translate into a fitter body and lower heart risks.

Posted in Heart Health on February 8, 2008
Reviewed July 2009

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