Understanding Gender and Genetics in the Battle Against Heart Disease

Hands on pregnant belly

When it comes to gender and heart disease, it’s now known that not all things are equal, according to Jennifer Lewey, MD, co-director of the Penn Medicine Pregnancy and Heart Disease Program.

“While a lot of the risk factors cut across both genders — smoking, being overweight, diabetes, high cholesterol and blood pressure — there are also risk factors that are unique to women, such as those related to pregnancy.”

Lewey explains that women who experienced conditions such as preeclampsia, gestational diabetes or hypertension during pregnancy are more likely to have a heart attack later in life.

Why is this?

Gender-Specific Cardiac Risk Factors

According to the American College of Cardiologists, gestational diabetes alone can double a woman’s risk of heart attack and stroke by influencing the development of early atherosclerosis before the onset of type 2 diabetes and metabolic diseases, conditions that have been linked to heart disease.

In the case of preeclampsia, a 2017 research study found that this condition may actually change the way that a woman’s blood vessels function, causing its effects to be felt long after delivery. This can greatly increase a woman’s lifelong risk of cardiovascular disease.

Lewey adds that delivering a baby prematurely — before 37 weeks — may also be an indicator that an individual is at risk of a structural heart problem and subsequent heart disease.

“Beyond this, we need to consider other conditions that are more common among women such as lupus or rheumatoid arthritis,” Lewey says. “Anxiety and depression are also seen more commonly among women. All of these have been linked to an increased risk of cardiovascular disease.”

“In their childbearing years, women have a different composition of hormones, estrogen and progesterone, than men,” explains Lewey. “We know that estrogen can protect a woman from heart disease, but after menopause women lose that protection.”

Managing Your Risk

So, what can a woman do to reduce her risk of developing heart disease when the genetic and gender cards seem stacked against her?

“Educate yourself,” says Lewey. “Talk to your doctor about high blood pressure and cholesterol, your risk of developing diabetes and whether your weight is within an appropriate range. Take a look at your overall health. Do you smoke, and can you quit? And are you getting the recommended 30 minutes a day of cardiovascular exercise? Finally, know your family history as this can play a role in determining your risk.”

Additionally, Lewey recommends that women — and men — follow a diet that is largely plant based, with lots of fruits and vegetables, and choose lean meats such as poultry and fish, to keep their heart as healthy as possible. Daily caffeine and alcohol are fine, but she emphasizes that these should be consumed in moderation.

“And everyone should know the symptoms of heart disease,” she adds. “If you’re experiencing symptoms such as heart palpitations, chest pain, shortness of breath, inability to exercise normally, tightness or pressure in your chest, lightheadedness, dizziness or pain in the neck, jaw or upper back, reach out to your doctor right away.”

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