Heart disease, often associated with men clutching their chest in distress, is, in reality, the leading cause of death for women in the United States. Nearly 45% of American women over 20 live with some form of cardiovascular disease. A new study from Intermountain Health in Salt Lake City underscores the urgent need for tailored care for women with heart disease.
Presented at the American College of Cardiology’s annual conference (ACC.25) in Chicago on March 31, the research reveals that while women still experience higher rates of heart disease-related deaths and events like heart attacks, the gap between men and women has been narrowing in recent years.
“The reality is that women are different from men and need to be evaluated, diagnosed, and treated differently for heart disease,” said Kismet Rasmusson, NP, principal investigator of the study. Rasmusson, a cardiovascular nurse practitioner at Intermountain Health’s Advanced Heart Failure Program, acknowledged the progress made in the local area, but stressed the continued need for research into the gender-specific aspects of heart disease.
The retrospective study analyzed health records of 14,248 women and 26,524 men who underwent coronary angiography at Intermountain facilities between 2000 and 2019. Coronary angiography is a procedure that uses X-rays and contrast dye to identify blockages in the coronary arteries, which can lead to heart attacks.
The study found that men were more likely to be smokers and had higher incidences of previous heart attacks, left ventricular dysfunction, and hyperlipidemia (elevated cholesterol and triglyceride levels). Women, on the other hand, tended to be older and had a higher prevalence of conditions like high blood pressure, diabetes, stroke, and heart failure. They also experienced less severe chest pain and had more stable conditions when arriving for catheterization.
Interestingly, the study revealed that while women had less severe blockage in their coronary arteries, they also had less revascularization—a medical procedure to restore blood flow—compared to men. Women with significant blockages were also less likely to receive prescriptions for cardiac medications proven to improve outcomes.
Despite these differences, the study showed a narrowing of the gender gap in cardiac outcomes. Over the course of the 19-year study, the rates of major cardiac events—such as heart attack and death—were higher in women, largely due to a higher mortality rate. However, by the 2015-2019 period, the difference in rates of major cardiac events between men and women had largely disappeared.
“Our findings mirror those of other studies, highlighting that women have unique risk factors, and their heart disease differs in terms of extent and location compared to men,” Rasmusson explained.
While the study provides valuable insights, it is limited to a single health system, and may not reflect broader national trends. However, it does underscore a critical gap in awareness. A 2009 survey revealed that 65% of women were aware of their heart disease risk. By 2019, that number had dropped to just 44%. A 2021 study published in Circulation confirmed that fewer than half of women are aware of their risk for heart disease, even as awareness of breast cancer risk has surged.
“We know that both locally and nationally, there is a lack of awareness and undertreatment of heart disease in women,” Rasmusson said. She pointed out that cardiovascular research and treatment have historically focused on men, leaving women underrepresented in studies and care.
“It’s essential that women recognize their risk of heart disease is just as significant as that of men. It is the leading cause of death, more than all cancers combined. Women must be empowered to manage their risk factors, recognize symptoms, and seek prompt care—this is key to improving outcomes,” she concluded.
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