Lifestyle
Women are at a higher risk of dying from heart disease − in part because doctors don’t take major sex and gender differences into account
Heart disease impacts women differently than men due to genetic and gender biases in healthcare. Awareness and improved treatment approaches are essential for better outcomes.
Last Updated on April 20, 2026 by Daily News Staff
Amy Huebschmann, University of Colorado Anschutz Medical Campus and Judith Regensteiner, University of Colorado Anschutz Medical Campus
A simple difference in the genetic code – two X chromosomes versus one X chromosome and one Y chromosome – can lead to major differences in heart disease. It turns out that these genetic differences influence more than just sex organs and sex assigned at birth – they fundamentally alter the way cardiovascular disease develops and presents.
While sex influences the mechanisms behind how cardiovascular disease develops, gender plays a role in how healthcare providers recognize and manage it. Sex refers to biological characteristics such as genetics, hormones, anatomy and physiology, while gender refers to social, psychological, and cultural constructs. Women are more likely to die after a first heart attack or stroke than men. Women are also more likely to have additional or different heart attack symptoms that go beyond chest pain, such as nausea, jaw pain, dizziness and fatigue. It is often difficult to fully disentangle the influences of sex on cardiovascular disease outcomes versus the influences of gender.
While women who haven’t entered menopause have a lower risk of cardiovascular disease than men, their cardiovascular risk accelerates dramatically after menopause. In addition, if a woman has Type 2 diabetes, her risk of heart attack accelerates to be equivalent to that of men, even if the woman with diabetes has not yet gone through menopause. Further data is needed to better understand differences in cardiovascular disease risk among nonbinary and transgender patients.
Despite these differences, one key thing is the same: Heart attack, stroke and other forms of cardiovascular disease are the leading cause of death for all people, regardless of sex or gender.
We are researchers who study women’s health and the way cardiovascular disease develops and presents differently in women and men. Our work has identified a crucial need to update medical guidelines with more sex-specific approaches to diagnosis and treatment in order to improve health outcomes for all.
Gender differences in heart disease
The reasons behind sex and gender differences in cardiovascular disease are not completely known. Nor are the distinct biological effects of sex, such as hormonal and genetic factors, versus gender, such as social, cultural and psychological factors, clearly differentiated.
What researchers do know is that the accumulated evidence of what good heart care should look like for women compared with men has as many holes in it as Swiss cheese. Medical evidence for treating cardiovascular disease often comes from trials that excluded women, since women for the most part weren’t included in scientific research until the NIH Revitalization Act of 1993. For example, current guidelines to treat cardiovascular risk factors such as high blood pressure are based primarily on data from men. This is despite evidence that differences in the way that cardiovascular disease develops leads women to experience cardiovascular disease differently.
In addition to sex differences, implicit gender biases among providers and gendered social norms among patients lead clinicians to underestimate the risk of cardiac events in women compared with men. These biases play a role in why women are more likely than men to die from cardiac events. For example, for patients with symptoms that are borderline for cardiovascular disease, clinicians tend to be more aggressive in ordering artery imaging for men than for women. One study linked this tendency to order less aggressive tests for women partly to a gender bias that men are more open than women to taking risks.
In a study of about 3,000 patients with a recent heart attack, women were less likely than men to think that their heart attack symptoms were due to a heart condition. Additionally, most women do not know that cardiovascular disease is the No. 1 cause of death among women. Overall, women’s misperceptions of their own risk may hold them back from getting a doctor to check out possible symptoms of a heart attack or stroke.
These issues are further exacerbated for women of color. Lack of access to health care and additional challenges drive health disparities among underrepresented racial and ethnic minority populations.
Sex difference in heart disease
Cardiovascular disease physically looks different for women and men, specifically in the plaque buildup on artery walls that contributes to illness.
Women have fewer cholesterol crystals and fewer calcium deposits in their artery plaque than men do. Physiological differences in the smallest blood vessels feeding the heart also play a role in cardiovascular outcomes.
Women are more likely than men to have cardiovascular disease that presents as multiple narrowed arteries that are not fully “clogged,” resulting in chest pain because blood flow can’t ratchet up enough to meet higher oxygen demands with exercise, much like a low-flow showerhead. When chest pain presents in this way, doctors call this condition ischemia and no obstructive coronary arteries. In comparison, men are more likely to have a “clogged” artery in a concentrated area that can be opened up with a stent or with cardiac bypass surgery. Options for multiple narrowed arteries have lagged behind treatment options for typical “clogged” arteries, which puts women at a disadvantage.
In addition, in the early stages of a heart attack, the levels of blood markers that indicate damage to the heart are lower in women than in men. This can lead to more missed diagnoses of coronary artery disease in women compared with men.
The reasons for these differences are not fully clear. Some potential factors include differences in artery plaque composition that make men’s plaque more likely to rupture or burst and women’s plaque more likely to erode. Women also have lower heart mass and smaller arteries than men even after taking body size into consideration.
Reducing sex disparities
Too often, women with symptoms of cardiovascular disease are sent away from doctor’s offices because of gender biases that “women don’t get heart disease.”
Considering how symptoms of cardiovascular disease vary by sex and gender could help doctors better care for all patients.
One way that the rubber is meeting the road is with regard to better approaches to diagnosing heart attacks for women and men. Specifically, when diagnosing heart attacks, using sex-specific cutoffs for blood tests that measure heart damage – called high-sensitivity troponin tests – can improve their accuracy, decreasing missed diagnoses, or false negatives, in women while also decreasing overdiagnoses, or false positives, in men.
Our research laboratory’s leaders, collaborators and other internationally recognized research colleagues – some of whom partner with our Ludeman Family Center for Women’s Health Research on the University of Colorado Anschutz Medical Campus – will continue this important work to close this gap between the sexes in health care. Research in this field is critical to shine a light on ways clinicians can better address sex-specific symptoms and to bring forward more tailored treatments.
The Biden administration’s recent executive order to advance women’s health research is paving the way for research to go beyond just understanding what causes sex differences in cardiovascular disease. Developing and testing right-sized approaches to care for each patient can help achieve better health for all.
Amy Huebschmann, Professor of Medicine, University of Colorado Anschutz Medical Campus and Judith Regensteiner, Professor of Medicine, University of Colorado Anschutz Medical Campus
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Consumer Corner
Cold cities are the most ready for winter, with one exception. See where your city ranks
Cold cities? Every neighborhood has a mix of homeowners who approach seasonal home maintenance differently – there are the people who stay on schedule, and on the other end, the procrastinators. There are the dedicated DIYers, and those who have their favorite maintenance pro saved as a favorite contact in their phone. As it turns out, cities are no different. Some metropolitan areas keep their neighborhoods in tip-top shape, while others are a little more slow-going.
Cold cities are the most ready for winter, with one exception. See where your city ranks
(Sheeka Sanahori) Every neighborhood has a mix of homeowners who approach seasonal home maintenance differently – there are the people who stay on schedule, and on the other end, the procrastinators. There are the dedicated DIYers, and those who have their favorite maintenance pro saved as a favorite contact in their phone. As it turns out, cities are no different. Some metropolitan areas keep their neighborhoods in tip-top shape, while others are a little more slow-going.
New data from home services company Angi, covering fall maintenance activity in August, reveals which U.S. metropolitan areas are the most proactive with fall maintenance. Washington, D.C., tops the ranking with the strongest demand for fall maintenance in the country, followed by Columbus, Ohio, and Milwaukee, Wisconsin. Northern cities dominate the rest of the list.
Cleveland, Ohio, and Albany-Schenectady-Troy, New York, round out the top five. Cold-weather markets dominate the ranking, accounting for eight of the 10 most-prepared metros. Rochester, New York; Charlotte, North Carolina; Chicago; Indianapolis; and Pittsburgh complete the top 10.
Least fall-ready metros
Fewer than 1 in 5 American cities is prepping for fall at an above-average rate. Among the 66 metros that recorded at least 100 fall maintenance service requests during the analysis period, Los Angeles had the lowest level of per-capita activity, followed by Oklahoma City and Riverside, California. California accounts for four of the bottom 10 markets, with Los Angeles, Riverside, San Diego and San Francisco all appearing on the list. These metros historically don’t experience the colder winter climates of the Northeast and Midwest, making fall maintenance less of an imperative.
Grand Rapids, Michigan, stands out as the only clearly cold-weather metro among the 10 least-prepared large metros. The New York City metro, which includes Newark and Jersey City, ranked just outside the 10 least-prepared large metros, coming in at number 11. Other New York state metros, including Syracuse, Rochester and the Albany metro area, were on the most prepared list.
Homeowners are choosing upkeep over upgrades
Sixty-three percent of homeowners who have recently hired a professional completed maintenance work, and 58% completed repairs. Although they may be waiting to do that dream kitchen or bath renovation, they’re focusing for now on the maintenance that keeps their homes in order.
The most common fall maintenance projects focus on outdoor upkeep. Nationally, tree trimming was the most popular, followed by lawn and yard waste cleanup and shrub care.
What homeowners should do now
When tackling a home maintenance list, start at the top of the home by inspecting the roof and gutters. Look for loose or damaged shingles, and make sure gutters are debris-free. It’s also a good idea to ensure downspouts direct water far away from the foundation. Homeowners should inspect these areas from the ground or hire a professional if the work requires climbing or feels unsafe.
Next, check for drafts around the windows and doors. Replacing worn weatherstripping and damaged caulk in the fall can prevent warm air from escaping once the heat comes back on. Homeowners should also inspect their HVAC filters and have the heating system checked before the temperatures drop.
Every home’s maintenance needs will vary, depending on the age and condition of the house and where it’s located. Whether homeowners hire a professional or safely address small issues, making the fixes can prevent larger and more expensive problems later.
The ranking: Metros from most to least prepared
America’s 10 Most Fall-Prepared Metros
1. Washington, D.C.
2. Columbus, Ohio
3. Milwaukee, Wisconsin
4. Cleveland, Ohio
5. Albany-Schenectady-Troy, New York
6. Rochester, New York
7. Charlotte, North Carolina
8. Chicago, Illinois
9. Indianapolis, Indiana
10. Pittsburgh, Pennsylvania
10 Metros With the Most Opportunity to Get Fall-Ready
1. Los Angeles, California
2. Oklahoma City, Oklahoma
3. Riverside, California
4. Miami, Florida
5. San Diego, California
6. Houston, Texas
7. Grand Rapids, Michigan
8. San Francisco, California
9. Austin, Texas
10. Memphis, Tennessee
Methodology
The rankings are based on fall maintenance activity recorded on Angi during August 2026. Projects included yard cleanup, winterization, roofing and gutters, heating systems, water and drainage, outdoor plumbing, fireplaces and chimneys, pest prevention, and snow and storm preparation. U.S. metropolitan areas were ranked by activity per 100,000 residents using 2020 U.S. Census population data. To qualify for the least-prepared ranking, metros were required to have at least five service requests or jobs during the analysis period. The rankings reflect activity on Angi’s platform and are not a complete measure of all home-maintenance activity within each metro. These rankings reflect activity observed on Angi’s platform and should not be interpreted as a complete measure of all home-maintenance behavior within a metro area.
Photo courtesy of Shutterstock
SOURCE:
Angi
College Life
Is College Worth It? New U.S. News Rankings Put More Weight on What Graduates Earn
Is college worth it? MIT has taken the No. 1 spot in the 2027 U.S. News Best Colleges rankings, ending Princeton’s 15-year run. But a new Earnings by Major metric could be even more important for families asking whether college is worth the investment.
For millions of students and families, choosing a college increasingly comes down to a basic question: Is college worth it?
The latest U.S. News & World Report Best Colleges rankings are attempting to provide another piece of information to help answer that question.
The 2027 rankings place the Massachusetts Institute of Technology (MIT) at No. 1 among National Universities, ending Princeton University’s 15-year run at the top. But perhaps the bigger story for prospective students isn’t which university occupies the No. 1 position.
It’s a significant change in how U.S. News measures the value of attending college.
For the first time, the rankings include an Earnings by Major factor designed to examine what graduates earn after leaving school — and to compare those earnings with graduates who studied the same subjects elsewhere.
Is College Worth It? U.S. News Looks Beyond Graduation
College has traditionally been promoted as an investment in a person’s future. But as families confront tuition, housing expenses and the possibility of student debt, simply earning a degree may no longer be enough information when deciding where — or whether — to attend.
Students increasingly want to know what happens after graduation.
The new U.S. News Earnings by Major metric examines graduate earnings four years after graduation using data from the U.S. Department of Education’s College Scorecard.
Importantly, the system doesn’t simply compare the average salary of graduates from one university with another.
Instead, earnings are compared within specific academic disciplines.
That distinction matters.
A university graduating large numbers of engineers, computer scientists or students entering other relatively high-paying occupations could otherwise appear to produce stronger financial outcomes simply because of the subjects its students choose to study.
Comparing graduates within similar fields is intended to provide a clearer picture of how graduates from different institutions fare financially.
From Student Debt to Graduate Earnings
The new Earnings by Major metric replaces the Graduate Indebtedness factor previously used by U.S. News.
That represents an important shift in perspective.
Instead of focusing primarily on how much debt students accumulate, the new measure looks at one aspect of what students may receive financially from their education after entering the workforce.
The metric examines employed federal financial aid recipients whose highest degree is a bachelor’s degree.
According to U.S. News, the approach is intended to reduce the influence of family financial advantages and provide a better indication of the economic value institutions may contribute to graduates.
That doesn’t mean earnings alone determine whether a college education is worthwhile.
But for a student potentially investing tens of thousands of dollars — and several years of their life — knowing how graduates in a particular major perform economically can be an important part of the decision.
MIT Takes the No. 1 Spot
Against that changing methodology, MIT moved into the No. 1 position among National Universities in the 2027 rankings.
The top three are:
- Massachusetts Institute of Technology
- Princeton University
- Harvard University
Princeton’s move to second place ends a run at No. 1 that began with the 2012 edition of the rankings.
Among National Liberal Arts Colleges, Williams College remained No. 1, followed by Amherst College at No. 2. Bowdoin College, Claremont McKenna College, Pomona College and Swarthmore College tied for third.
Nearly 1,700 institutions were evaluated in the 2027 edition.
Outcomes Are Becoming a Bigger Part of the Equation
The addition of graduate earnings is part of a broader emphasis on student outcomes in the U.S. News methodology.
U.S. News says outcomes now account for more than half of a school’s total score.
Institutions can be evaluated using as many as 17 weighted measures, including graduation and retention rates, social mobility for lower-income students, post-graduate earnings, faculty resources and academic peer assessments.
The shift reflects a changing conversation surrounding higher education.
For generations, students were often encouraged to focus heavily on getting into the most prestigious college possible. Today’s students may also be asking more practical questions:
How much will it cost?
How much financial aid will I receive?
How much debt might I have when I graduate?
What do graduates in my intended major earn?
And perhaps most importantly:
Will the investment pay off for me?
College Value Isn’t Just About Salary
Graduate earnings can provide useful information, but salary shouldn’t be treated as the sole measurement of the value of higher education.
Different careers have dramatically different compensation structures.
A graduate pursuing teaching, public service, social work, the arts or nonprofit work may earn less than someone entering engineering, finance or technology while still considering their education worthwhile.
There are also benefits of higher education that are difficult to capture in a salary statistic.
That’s why students comparing schools may want to look beyond an institution’s overall ranking and examine factors such as net price after financial aid, scholarships, graduation rates, student debt, internship opportunities, career placement, location and the strength of the program they actually intend to study.
The best-known university isn’t automatically the best financial or educational choice for every student.
Economic Diversity Also Gets Attention
The 2027 rankings also highlight economic diversity among highly ranked institutions.
According to U.S. News, MIT and Princeton rank third and fourth, respectively, among the top 25 National Universities in the percentage of students receiving federal Pell Grants.
Pell Grants generally assist undergraduate students with significant financial need and typically do not have to be repaid.
Among the top 25 National Liberal Arts Colleges, Amherst College ranked highest for economic diversity under the U.S. News measure.
A New Ranking Looks at In-State Value
U.S. News is also placing additional attention on affordability for students considering public universities.
The 2027 edition introduces a Best Value Schools for In-State Students ranking, which evaluates public universities based on academic quality and affordability for residents.
The University of North Carolina at Chapel Hill took the No. 1 position in the inaugural ranking.
That category could be particularly relevant to families deciding whether the prestige associated with attending a private or out-of-state university justifies potentially higher costs compared with attending a public institution in their home state.
The Rankings Look Different This Year
There is another important caveat when comparing the 2027 results with previous years.
Changes to the Carnegie Classification framework resulted in approximately 20% of previously ranked institutions moving into different U.S. News categories.
Because some colleges are now being compared against different groups of institutions, their 2027 rankings may not be directly comparable with previous years.
The changes also expanded eligibility, allowing additional institutions specializing in areas such as engineering, business and health to enter the rankings.
U.S. News also introduced an undergraduate economics specialty ranking while continuing rankings covering areas such as social mobility, innovation, historically Black colleges and universities, artificial intelligence programs, internships, undergraduate research and study-abroad opportunities.
Public Universities, HBCUs and Social Mobility
Among public National Universities, the University of California, Berkeley and UCLA tied for the No. 1 position, followed by the University of Michigan–Ann Arbor.
The top three Historically Black Colleges and Universities were:
- Spelman College
- Howard University
- Tuskegee University
For social mobility among National Universities, Florida International University and the University of California, Riverside tied for No. 1, with Oakland City University ranked third.
These categories illustrate another reason students may want to look deeper than a school’s overall national position. Different rankings can reveal institutions performing particularly well in areas that may matter more to an individual student.
So, Is College Worth It?
There isn’t one answer that applies to every student.
The cost of attending, financial aid, chosen major, career goals, likelihood of graduating and potential debt can dramatically change the financial equation.
A college with a famous name and high national ranking could be a poor financial choice for one student while a less prominent public university with generous financial aid could be an excellent investment for another.
That’s what makes the addition of Earnings by Major noteworthy.
Instead of asking only “Which college ranks highest?”, prospective students now have another reason to ask a much more personal question:
“What am I paying for — and what could I realistically get in return?”
MIT replacing Princeton at No. 1 makes the headline.
But for students and parents trying to decide whether college is worth the cost, the growing emphasis on outcomes, affordability and post-graduation earnings may ultimately be the more important story.
Source: U.S. News & World Report, 2027 Best Colleges rankings, released September 22, 2026.
U.S. News & World Report press release:
MIT Claims No. 1 Spot in U.S. News 2027 Best Colleges Rankings PR Newswire
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Health
Type 2 Diabetes Doesn’t Have to Be Your Future: Medicare Has a Benefit That Can Help
Left unchecked, prediabetes can progress to type 2 diabetes. However, with the right support, prediabetes can often be managed or even reversed. If you have Medicare, you may qualify for a Medicare-covered program that can help you lower your chances of developing type 2 diabetes – at no cost to you.
(Feature Impact) Nearly 1 in 2 people age 65 and older has prediabetes – a condition where blood sugar (glucose) levels run higher than normal. Left unchecked, prediabetes can progress to type 2 diabetes. However, with the right support, prediabetes can often be managed or even reversed. If you have Medicare, you may qualify for a Medicare-covered program that can help you lower your chances of developing type 2 diabetes – at no cost to you.
The Medicare Diabetes Prevention Program is a covered Medicare benefit that gives you practical tools, personalized support, and proven strategies to make healthy lifestyle changes. Learn how to eat better, exercise more, and build healthy habits that stick while guided by a certified coach who helps you every step of the way.
Research shows the program works. People with prediabetes who complete the program result in weight loss, which ultimately leads to reduced risk of type 2 diabetes onset.
What can you expect?
Prevention does not mean you have to make big changes all at once. This program helps you take small, realistic steps that can add up to lasting results. It includes 16 core sessions where you can learn how to reduce your diabetes risk by making healthier meals, moving more, and building healthy habits.
The core sessions are followed by six months of monthly maintenance sessions to help you keep your momentum.
You can choose the class format that works for you
You can enroll in these services from approved Medicare Diabetes Prevention Program suppliers and participate in the way most convenient for you:
- In-Person: Attend sessions in a community location.
- Live-Distance Learning: Join interactive group sessions from home.
- Self-Paced Online: This new option allows you to access online content and learn on your own schedule.
Visit www.medicare.gov/PreventDiabetes to find a class that’s right for you.
Who is eligible?
You may qualify if you are enrolled in Medicare Part B and meet these criteria:
- Have had one of the following test results within the past 12 months:
- Hemoglobin A1c between 5.7% and 6.4%
- Fasting plasma glucose between 110 and 125 mg/dL
- Two-hour plasma glucose between 140 and 199 mg/dL after an oral glucose tolerance test
- Have a body mass index (BMI) of 25 or higher (or 23 or higher if you self-report as Asian descent).
- Have never been diagnosed with type 1 or type 2 diabetes or end-stage renal disease (ESRD).
What does it cost?
If you have Medicare Part B and qualify for the program, you pay nothing to participate. If you are in a Medicare Advantage Plan, you may have to go to an in-network provider to get these services. Contact your plan for more information.
Ready to get started on your healthier future?
Take control of your health on your own terms, schedule, and pace that fits into your life. Check with your doctor to find out if you have prediabetes or are at risk for developing type 2 diabetes. If you’re eligible for the Medicare Diabetes Prevention Program, your doctor can refer you, or you can enroll on your own.
If you’re ready to get started today, find the class that’s right for you at: www.medicare.gov/PreventDiabetes.
Information provided by the U.S. Department of Health and Human Services
Photos courtesy of Shutterstock
SOURCE:
Centers for Medicare & Medicaid Services
