Part 1 of 2

Cardiovascular disease in women and men - what's the difference?

Cardiovascular disease (CVD) is the leading cause of death worldwide. The two biggest killers are coronary heart disease (CHD) and stroke.

In 2017, around
17.8 million people died
from CVD, such as CHD & stroke

Each person below represents ~125,000 people.

CVD: 17.8 million deaths

32% of all deaths

CHD: 8.9 million deaths

16% of all deaths

stroke: 6.2 million deaths

11% of all deaths

other CVDs: 2.7 million deaths

5% of all deaths

Source: GHDx

What is CHD?

CHD is a disease of the blood vessels supplying the heart (also known as 'ischemic heart disease')

Major risk factors: High blood pressure, high blood cholesterol, tobacco use, unhealthy diet, physical inactivity, diabetes, advancing age, inherited (genetic) disposition.

Other risk factors: Poverty, low educational status, poor mental health (depression), inflammation and blood clotting disorders.

Source: WHO

For this piece, CHD refers to CD-10 codes I20–I25 ('B.2.2 Ischemic heart disease' on GHDx)

What is stroke?

Strokes are caused by a disruption of the blood supply to the brain. This may result from either blockage (ischaemic stroke) or rupture of a blood vessel (haemorrhagic stroke).

Risk factors: High blood pressure, atrial fibrillation (a heart rhythm disorder), high blood cholesterol, tobacco use, unhealthy diet, physical inactivity, diabetes, and advancing age.

Source: WHO

For this piece, stroke refers to CD-10 codes I60-63, I65-69 & G45-46 ('B.2.3 Stroke' on GHDx)

Deaths from CHD and stroke occur differently in women and men.

Stroke is more prevalent among women, and a greater percentage of women die from it than men. It often occurs at an older age in women.

11.7% of deaths due to stroke
15.6% of deaths due to CHD

CHD is more prevalent among men, and a greater percentage of men die from it than women. It often occurs at a younger age in men.

10.5% of deaths due to stroke
16.0% of deaths due to CHD

Source: GHDx

CVD is often thought as a "man's problem".
However, globally, a higher proportion of female deaths are due to CVD.
Of all deaths amongst men, 30.8% are due to CVD.
Of all deaths amongst women, 33.0% are due to CVD.

Source: GHDx

Women and men experience CVD in different ways, including symptoms, access to care and even treatment.

In the past it was widely assumed that the occurrence and outcomes of CVDs such as CHD and stroke were the same for men and women, and that what was learnt from studies involving only men would be equally applicable to women.1

It is now recognised that there are a range of differences, from how a disease presents itself and what symptoms are considered 'typical', to the ability to access health care and the treatment given. For example:

  • Studies have found that when women are given statins it is often at lower intensities than the guidelines recommend1
  • Female patients of male cardiologists have been found to have worse outcomes than males (with no such difference for male patients of female cardiologists)2
  • Certain lifestyle factors such as smoking, diabetes, and high blood pressure increase the risk of a heart attack in women more than in men3

1. Women less likely than men to receive high-intensity statins following a heart attack
2. Cardiovascular Disease and the Female Disadvantage
3. Smoking, diabetes and high blood pressure increase women’s risk of experiencing a heart attack more than men’s, new research shows

We believe that ones' health and life expectancy shouldn't be determined by geography, socioeconomic status, fate – or gender

Professor Robyn Norton, "Urging a New Global Agenda for Women's Health"

Professor Robyn Norton