High blood pressure, smoking increases risk of heart attack in women, study says



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Hypertension, smoking and diabetes increase the risk of heart attack in a woman more than these factors increase a man's risk, according to a new study published in the BMJ.

The rate of heart attacks in men remains three times higher than in women, according to researcher Elizabeth Millett, an epidemiologist at the George Institute for Global Health at the University of Oxford. But the study found that these three individual factors – smoking, diabetes and hypertension – are more likely to be linked to heart attacks in women, showing the need for more awareness-raising efforts directed at women on the issue of heart disease.

Millett's work is part of a larger study bank on gender differences in noncommunicable diseases by the George Institute.

"This strengthens the need for people to remember looking at women and men when they study heart attacks," Millett said.

Because her most recent work is an observational study that fails to explain causes, Millett emphasized the need for more research on why this gender difference exists.

Almost half a million Britons enrolled in the UK Biobank were studied. They were between the ages of 40 and 69 and were recruited between 2006 and 2010. They were followed up by an average of seven years by Millett's team. Of the 471,998 participants, none had a history of cardiovascular disease. Researchers found that 5,081 of these people had their first heart attack during the course of the study, 28.8% of them women.

Hypertension was the main factor; This raised the risk of a woman's heart attack by 83 percent more than increased risk in one man. Smoking increased the risk of heart attack by 55 percent in a woman, while type 2 diabetes – which is linked to a poor diet – had a 47 percent greater impact on heart attacks among women compared to men.

Studies have identified some risk factors that affect women at a higher rate than men. Millett's study examined the impact of three of these risk factors and found that their disproportionate impact on women persisted throughout their age.

Deaths from heart attacks are lower among women than among men at younger ages, according to the study, and previous research has shown that women experience the first heart attack nine years later than men on average.

Combined with an aging population, this is likely to be the case for "women reaching men" in terms of heart attack rates, Millett explained. This would cause "a significant additional burden on society and health care resources," the study authors noted.

The study has some limitations. The UK Biobank project consists mainly of white participants, making it difficult to generalize the results to other groups. Millett also said that the participants examined were slightly higher socioeconomic status than others in the UK.

"Regardless of their sex, risk factors like high blood pressure, smoking and diabetes increase the risk of a heart attack. These findings should not divert attention from a joint effort to better detect and manage risk factors that can be altered, "Professor Metin Avkiran, associate medical director of the British Heart Foundation, wrote in an e-mail.

According to the British Heart Foundation, about 188,000 hospital visits per year are due to a heart attack. Every year, about 735,000 Americans have a heart attack, according to the US Centers for Disease Control and Prevention.

"What we want is for women to be more aware that heart attacks happen to both women and men," Millett said. She believes there is a lack of awareness in women about heart disease because men are most affected by them.

The study also highlights the need for doctors to be vigilant when their female patients are elderly, smoke, have diabetes or have high blood pressure. Doctors should ensure that women and men have equal access to health programs that address these conditions, the researchers said.

Millett added that awareness is crucial because the symptoms of heart attack may differ for both men and women. Some symptoms – such as unusual tiredness, dizziness or cold sweats – are more common in women than in men, she explained.

"It is absolutely vital that everyone has equal access to the best advice and treatment regardless of age, gender or socioeconomic status," Avkiran wrote. "This is an important reminder that heart disease does not discriminate, so we need to change perceptions that it affects only men."

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