Sexual Inequality Strikes Again... in Heart Attacks

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In matters of the heart, women and men are different. Those are the findings of two major heart attack studies published in Thursday’s issue of the New England Journal of Medicine. The new research adds perspective and new details to the long-known fact that, in general, when women suffer heart attacks they are more likely to die than men. "The research found that after age 74, men and women die at about the same rate from heart attacks," says TIME medical columnist Christine Gorman. "But under age 74, women have a higher mortality rate, and the younger the age, the bigger the difference between women and men." So for example, while women under 50 are less likely to suffer a heart attack than men, when they do they are twice as likely to die.

Traditional medical wisdom has attributed the difference to various factors: Women are more likely to also suffer from diabetes, more likely to delay going to the hospital and less likely than men to get prompt heart attack treatment once under medical care. While all of this is true, says Gorman, "the researchers found that these factors account for only a third of the difference. The rest of the difference was so big that the researchers believe there must also be something physiological at work." For instance, one of the studies found that younger women who suffer heart attacks are less likely to have the fatty buildup that is common in men, prompting speculation that in women the heart attack was more likely to be caused by a combination of blood clots and spasms in blood vessels. "But for now," says Gorman, "nobody knows what the physiological differences are." That more research is needed is now evident, as is the need for women to better acquaint themselves with the risk factors and symptoms of heart disease.