- A new study examines differences in heart disease risk between males and females.
- The researchers find that an increased risk in males begins much earlier in adulthood than expected.
- More surprisingly, this effect was still present after controlling for other factors, such as the protective nature of female sex hormones.
Specifically, by the age of 50.5 years, 5% of males have cardiovascular disease, but females do not reach this level until 57.5 years.
The analysis showed that this divergence in risk begins as early as 35 years of age.
Based on this, the authors suggest that the third decade of life should be a time for “more intensive screening and detection” in males.
Scientists have known for a long time that males are more likely to experience coronary heart disease (CHD) around 10 years earlier than females.
However, there has been little research into the sex differences regarding other heart-related conditions, such as heart failure and stroke.
Alongside this question, the authors of the new paper sought to understand whether recent lifestyle changes might make a difference.
For instance, historically, males had higher rates of smoking, diabetes, and high blood pressure, all of which increase cardiovascular risk. More recently, this difference between sexes has almost disappeared.
How might these demographic changes influence sex differences in heart disease?
These 5,112 participants enrolled in the study, ages 18–30, and were followed for over 30 years.
The scientists had three related objectives:
- Investigate sex differences in the age of onset for premature cardiovascular disease (under 65 years) and its different forms.
- Estimate 10‐year cardiovascular event rates through midlife for males and females and the difference between them.
- Explore whether differences in cardiovascular health measures, such as smoking or physical activity, reduce these sex‐based differences in risk.
Their analysis demonstrated that males had a significantly higher “cumulative incidence” of cardiovascular disease, heart failure, and CHD. In other words, over the course of the study’s follow-up, a greater proportion of males than females developed one of the conditions in question.
However, they identified no difference in stroke incidence.
The scientists also found that males reached 5% incidence of cardiovascular disease seven years earlier than women (50.5 versus 57.5 years).
A similar, but less pronounced, effect was observed for CHD. The researchers found that males reached a 2% incidence around 10 years before females.
For stroke and heart failure, however, males and females were much more aligned. They reached 2% stroke and 1% heart failure incidence at a similar age.
Real difference starts at age 35
Importantly, the scientists concluded that the differences between males and females in cardiovascular disease, CHD, and heart failure started diverging at the age of 35. The authors write:
“We quantify, for the first time, that sex differences in 10‐year CVD event rates first emerge at age 35 and persist throughout middle adulthood.”
Medical News Today contacted Dr. Raj Dasgupta, chief medical advisor for Sleepopolis, for comment. “Up until the early 30s, risk levels are similar, but by about age 35, men begin to accumulate risk faster than women,” he explained.
“This divergence happens well before most routine screenings are recommended, even though we know cardiovascular disease is something that develops over decades,” he said.
In agreement, the authors of the study write that “the fourth decade of life is a critical life period” and that more intensive screening and detection of subclinical cardiovascular disease may be warranted to help prevent future disease.
“My advice to everyone, men and women, is to adhere to a healthy lifestyle, not only because it might help you live longer, but keeping in reasonable shape will certainly improve your quality of life.” Dr. Peter Kowey told MNT.
Kowey, who was not involved in the study, is a professor of medicine and clinical pharmacology at Thomas Jefferson University in Philadelphia, PA, and author of the book Failure to Treat.
Specifically, he suggested “regular exercise, a prudent diet, smoking avoidance, moderate alcohol consumption, and stress management. None of these things should be sex or age-dependent but should be the rule for every adult.”
Adding to this advice, Dasgupta also suggested building heart-healthy habits now, whatever your age, including the importance of managing stress and sleep.
“Early intervention and risk factor control give you the best chance of shifting your long-term trajectory,” he explained.
Diet is one of the most important pillars of a healthy heart. As Kowey told MNT, “The consumption of ultra-processed food is off the charts, spurred by popular advertising, and clearly has a detrimental effect on cardiac health.”
The fact that these foods tend to be more cost-effective than fresh produce helps explain why poverty helps fuel the obesity epidemic, he told us.
Dasgupta suggested people should primarily focus on consuming “vegetables, fruits, whole grains, legumes, lean proteins, and healthy fats” and limiting “sugary drinks and excessive sodium.”
Dasgupta also explained that the Mediterranean diet, or DASH (Dietary Approaches to Stop Hypertension) diet, has the best supporting evidence when it comes to heart health. MNT has a guide to the DASH diet and Mediterranean diet for more details.
Consuming high levels of saturated fat is associated with an increased risk of heart disease. Recently, however, saturated fat — for instance, in the form of butter and tallow — has made a comeback.
Speaking with MNT, Dr. Eve Elizabeth Pennie, a physiologist and epidemiologist at Drugwatch, who was not involved in the research, said, “Saturated fat intake remains closely linked to higher LDL cholesterol levels, a major risk factor for heart disease.”
We also asked Kowey for his thoughts on this:
“It is a totally absurd idea emanating from a few misguided individuals. What needs to be emphasized is the need for a balanced diet that can include meat and dairy but should also include significant portions of fruits and vegetables.”
According to Dasgupta, “Diets that have a lot of processed meats and saturated fats without balancing them out with fiber, antioxidants, and healthy fats are still associated with a higher risk of heart disease.”
