Why atherosclerosis puts older women at greater risk

Few would disagree with the notion that women – certainly historically – haven’t always enjoyed the advantages in life that men have. The gender pay gap is one example that springs to mind. Now, new research has proffered another example in which women appear to lose out to men – atherosclerosis.

The simplest definition of atherosclerosis is clogged arteries. And while both men and women can suffer from the condition, it presents a greater risk to women. To be more precise, it appears to be older women who are most at risk of an adverse health event.

Research recently published in the European Heart Journal – Cardiovascular Imaging, explains further. It found postmenopausal women with atherosclerosis are at greater risk of heart attack than men of the same age.

The study’s findings were presented to EACVI 2023, a scientific congress of the European Society of Cardiology.

Interestingly, the research showed no real difference in the risk of heart attack between younger men and women. The imbalance occurs after 55, in particular in women who have reached the postmenopausal stage of life.

What causes arthrosclerosis?

Regular readers of YourLifeChoices health articles might recall ‘plaque’ in the brain being a risk factor for dementia. Abnormal levels of a naturally occurring protein clump together to form plaques that collect between neurons and disrupt cell function.

In a similar way, plaque can form in your arteries, disrupting blood flow. In the case of your arteries, the make-up of the plaque differs to that of the brain. Rather than proteins, the culprits are cholesterol, fat, blood cells and other substances in your blood that form the plaque.

Why older women?

That’s a good question, and one to which the answers are still being debated. Dr Sophie van Rosendael, researcher at Leiden University Medical Center in The Netherlands has one suggestion. The study’s lead author said it “could be partly because the inner diameter of coronary arteries is smaller in women”. This would mean that the same amount of plaque could have a larger impact on blood flow, she said.

The study took in more than 23,000 men and women. Overall, 11,678 women (average age 58.5 years) and 13,272 men (average age 55.6 years) were followed for 3.7 years. Results showed an approximately 12-year delay in the onset of coronary atherosclerosis in women.

In simple terms, that means women in general won’t develop obstructive atherosclerosis until a later age than men. Yet despite that, their risk of heart attack is higher. “It was formerly thought that only obstructive atherosclerosis caused myocardial infarction,” said Dr van Rosendael. “But we now know that non-obstructive disease is also risky.”

Prevention is better than cure

While the study’s authors said more studies are required to confirm their findings, theirs opens the door to prevention.

“Since atherosclerotic plaque burden is emerging as a target to decide the intensity of therapy to prevent heart attacks, the findings may impact treatment,” said Dr van Rosendael. “After menopause, women may need a higher dose of statins or the addition of another lipid-lowering drug.”

So, if you are a postmenopausal woman, you may have a higher risk than a man your age. Is there is anything practical you can do to mitigate that risk? That’s debatable, but regular GP health checks are always a good idea.

Were you aware of atherosclerosis and its associated risks? Will these findings change your attitude towards heart health? Let us know in the comments section below.

Also read: Almost half can’t identify heart attack symptoms, study finds

Health disclaimer: This article contains general information about health issues and is not advice. For health advice, consult your medical practitioner.

Andrew Gigacz
Andrew Gigaczhttps://www.patreon.com/AndrewGigacz
Andrew has developed knowledge of the retirement landscape, including retirement income and government entitlements, as well as issues affecting older Australians moving into or living in retirement. He's an accomplished writer with a passion for health and human stories.
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