We’ve already explored the different heart attack symptoms for men and women, but risk factors, underlying causes, and outcomes are also different, according to a scientific statement published in the American Heart Association’s (AHA) journal Circulation. Among the statement highlights:

  • Women frequently have different underlying causes of heart attacks than men, such as the types of plaque buildup.
  • Compared to men, women tend to be undertreated and are less likely to participate in cardiac rehab after a heart attack.
  • Risk factors such as high blood pressure and diabetes increase heart attack risk in women more severely than in men.

The statement also found that the differences in risk factors and outcomes are further pronounced in black and Hispanic women.

Different causes

Despite dramatic declines in cardiovascular deaths over the last decade due to improving treatments, heart disease remains the number one killer of women in the United States.

Blockages in the main arteries of the heart lead to heart attacks in both men and women, but the way the blockages form a blood clot may differ, the AHA says. Compared to men, women tend to have less severe blockages that usually do not require any stents; but the blockages still cause their coronary artery blood vessels to be damaged, resulting in decreased blood flow to the heart muscle.

If doctors don’t correctly diagnose the underlying cause of a woman’s heart attack, they may not be prescribing the right treatments before and after the heart attack.

Johns Hopkins Medicine says other risk factors that can affect women disproportionately include:

  • Increasing hypertension during menopause
  • Autoimmune diseases such as rheumatoid arthritis
  • Stress and depression
  • Low risk factor awareness: the lack of recognition of the above conditions as risk factors for heart disease is a risk factor in itself.

Less likely to seek treatment

As with men, the most common heart attack symptom for women is chest pain or discomfort, but sometimes chest pain is not present, making the heart attack more difficult to detect. This is known as a silent heart attack and is more deadly to women, according to a separate study in the journal Circulation.

Signs of a silent heart attack can include unexplained fatigue and discomfort in the jaw, upper back, or arms, according to CNN Health. The problem is that women often chalk up these symptoms to less life-threatening conditions like acid reflux, the flu, or normal aging, according to the AHA.

“They do this because they are scared and because they put their families first,” Nieca Goldberg, MD, told AHA. “There are still many women who are shocked that they could be having a heart attack.”

Are you a woman who has had heart trouble? Share your experiences by commenting below.