Heart to Heart: How Your Sex Can Determine Unique Heart Disease Risks

Heart disease is an equal-opportunity threat to both women and men and women. Like flipping a coin, the disease is as likely to affect a female as it is a male.

In fact, it’s the leading cause of death for both sexes and individuals of most ethnic backgrounds in the U.S., and one American dies every 36 seconds from a cause related to cardiovascular disease.

Since it’s so common (and so deadly), read on for some news that you’ll surely want to take to heart, plus score advice about how to reduce your risk regardless of your genetics and your DNA.

Heart Disease 101

Cardiovascular disease, aka heart disease, is any condition that impacts the heart or blood vessels, such as stroke, heart attack, or heart failure. As mentioned, it poses a strong risk for all humans, especially Americans who consume a Western diet. Some risks are shared among men and women, and others are surprisingly sex-specific.

The output of the heart is six quarts per minute or about 2,000 gallons per day. (To put that into perspective, that’s about 17 gas tanks-worth!) Blood leaves the heart flowing through the aorta and passes through blood vessels called arteries, which then fork off into smaller arteries and capillaries to supply the body with oxygen through red blood cells. Over time, plaque can accumulate in vessels along the way, which can either slow blood flow within the body or break off and block blood flow enough to trigger a stroke or heart attack.

Heart Disease Risk Factors Shared By Men and Women

Family genetics can certainly play a role in the development of cardiovascular disease, however, it’s actually less of a factor than you might expect. The incidence of one potential cause of heart disease, “familial hypercholesterolemia,” the inherited form of high cholesterol, is only 1 in 500 or 0.2% of the U.S. population.

Since the genes we’re born with aren’t something we can change—and since our lifestyle habits and individual health decisions can make a huge impact—we’ll focus on the latter.

The primary risk factors for heart disease for both sexes include:

• Age. Most of those who die from heart disease are over 65. Heart disease can happen at any time during the lifespan, but plaque build-up is more common as we get older, and the risk of dying increases as well.
• Poor diet. What we feed our bodies on a daily basis makes a big difference. Highly processed, high-sugar, low-fiber, and meat-heavy diets are particularly challenging for your heart to manage.
• Low amounts of physical activity. Regular exercise (150 minutes of moderate or 75 minutes of vigorous aerobic activity per week, plus twice-weekly strength sessions) can lower heart disease risk and may help keep blood pressure, cholesterol and weight in check.
• Excess weight. Being overweight or obese—even absent of other heart disease risk factors — raises the risk for heart disease. This is especially true if the extra fat accumulates near the midsection. The good news: Those who are overweight who lose just 3 to 5 percent of their body weight face significantly less risk than if they stayed at their current weight. (In a 250-pound person, that would mean dropping 7 ½ to 12 ½ pounds and keeping it off.)
• High cholesterol. As the level of bad (LDL) cholesterol blood cholesterol increases, heart disease risk does the same.
• High blood pressure. This forces the heart muscle to work harder, and over time, causing its walls to thicken and stiffen.
• Uncontrolled diabetes. When glucose and blood sugar levels fluctuate, cardiovascular disease risk jumps.
• High levels of stress. In addition to making your blood pressure rise, this can potentially lead to other unhealthy coping mechanisms, such as overeating, overconsumption of alcohol, or smoking cigarettes.
• Excess alcohol consumption. Some studies suggest low levels of drinking alcohol (e.g., one or fewer drinks per day) may help safeguard people against heart disease. However, drinking alcohol in excess can hike blood, pressure, cholesterol, and the risk of obesity and cancer.
• Tobacco use. Smokers are much more likely to develop cardiovascular disease, as are those frequently exposed to second-hand smoke.

While these all independently impact cardiovascular disease risk, they can compound on one another. The more risk factors you have, the higher the overall heart disease risk.

Heart Disease Risk Factors Unique to Women

Although some still consider cardiovascular disease to be more of an issue among males, just as many American women die from heart disease as men. It’s responsible for about one in every five female deaths in the U.S.

After Menopause

Prior to menopause, the hormone estrogen provides a protective effect for women, as it positively affects cholesterol levels and can offer a protective effect on blood vessels. After menopause, however, women lose this advantage and the risk of cardiovascular disease rises to equal men. Estrogen replacement therapy would seem to be a simple solution. But when estrogen is taken orally, it’s metabolized by the liver in a way that increases coagulation factors in the blood, which increases the risk of plaque formation.

Here are some additional risk factors unique to women:

• Blood cholesterol. Between puberty and perimenopause, estrogen can increase good (HDL) and decrease bad (LDL) cholesterol. Post-menopause, women tend to have higher total cholesterol and triglycerides than men.
• Diabetes. The presence of diabetes increases heart disease risk more among women than men, and women with diabetes are twice as likely to have a second heart attack compared to their non-diabetic peers.
• Tobacco. Women struggle more than men to quit, perhaps due to the menstrual cycle’s role in triggering withdrawal symptoms. Females who smoke are more likely to suffer from a heart attack than men.
• Artery Size. Since females have smaller arteries than men, it’s more challenging for doctors to detect or care for heart disease in female bodies using options like coronary bypass surgery, angiography, and angioplasty. Women are also at increased risk for post-surgical complications.

Heart Disease Risk Factors Unique to Men

About one in every four male deaths can be traced back to heart disease, and men tend to develop heart problems a decade earlier than women.

Men naturally have a higher concentration of red blood cells than women, which increases the blood viscosity, or thickness of the blood. Donating blood regularly is one way that men can reduce related risks of this less-easy-flowing blood.

Interestingly, erectile dysfunction (ED) can be an early warning sign of cardiovascular illness. Both the heart and the penis are vascular organs. But unlike the heart, the arteries that supply the penis with blood are much smaller, so low blood flow to this area can be a hint that the heart may face challenges later on. Males in their 40s who have erection challenges have an 80 percent risk of being diagnosed with heart disease in the next 10 years.

In addition, these risk factors are unique to males:

• Low Testosterone. This hormone isn’t just related to sex drive; it’s also connected to type 2 diabetes and heart disease risk. Males with metabolic syndrome (a cluster of conditions including abdominal obesity, high cholesterol, and high blood sugar) tend to have low testosterone, which plays a role in overall risk.
• Chronic Stress. While both men and women face stressors, we often express it differently. Males who face chronic stress are at higher risk for stroke, arterial damage, and heart attack, not to mention the trickle-down effect on other heart-harming habits, like lack of quality sleep and potential use or overuse of substances like tobacco and alcohol.

How to Reduce Your Risk of Heart Disease

Think Holistically

Since lifestyle and diet are foundational to good health, we can all start by adding more whole foods, especially vegetables, to our menus, and eating fewer processed foods, refined carbs, and red meats while avoiding alcohol or consuming it in moderation. Aiming to hit our exercise quota each week and implementing stress-relieving practices, including getting good sleep, are also part of a heart-healthy prescription. And of course, if you use tobacco or have diabetes, get extra support from your medical team to help eliminate or minimize these risk factors for heart disease.

Explore Natural Options

Doctors often prescribe statins to lower LDL cholesterol, which block the enzyme associated with the synthesis of cholesterol by the liver. But because this enzyme is also essential for various other functions in the body, side effects such as muscle pain and fatigue are common.

The most effective natural alternative for statins is a substance called red rice yeast. In fact, the original statin drug was derived from this source. Though red rice yeast isn’t as potent as statins, it has a lower risk for side effects. This yeast (Monascus purpureus) grows on white rice that produces “monacolins,” phytochemicals that block the creation of cholesterol.

Reducing your cardiovascular disease risk isn’t just about cholesterol, though. In addition to red rice yeast, many herbal supplements provide antioxidant protection and blood-thinning properties. When consumed in the appropriate amounts, these can keep blood flowing smoothly through the body. Some top choices for protecting the vascular system include resveratrol from herbs like Japanese knotweed, hawthorn, pine bark extract, and omega-3 fatty acids like those found in krill oil.*

There are also supplements that have been proven to offer anti-inflammatory, blood pressure-lowering, or other cardio-protective benefits including garlic, berberine, milk thistle, nattokinase/serrapeptidase.*

Support Your Liver

Regardless of any genetic tendencies, cholesterol levels typically rise in all humans over time as liver function declines. This means that protecting liver cells is extremely important as we age. Clean water, food, and air are all vital to maintaining liver function. In addition, many herbs directly protect liver cells. One that stands out is milk thistle, which has been shown to actually stimulate the regeneration of liver cells.*

The Bottom Line on Heart Disease Risk Factors

Though heart disease is an equal threat for both women and men, it’s wise to be keenly aware of the unique risk factor differences. There are many lifestyle and natural options to choose from that can help reduce the risks. The important thing is to listen to your heart and start taking action today.

* Always speak to your doctor before starting any new medicine or supplement.