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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Food and Beverage
Beyond Protein: 2 Nutrients Your Plate Might Be Missing
Nutrients: Everyone is talking about protein these days whether watching their weight or managing a disease like type 2 diabetes. However, fiber and healthy fats are nutrients many people are overlooking. One food that makes it easier to invest in your health, according to nutrition experts: avocados.
Beyond Protein: 2 Nutrients Your Plate Might Be Missing
(Feature Impact) Everyone is talking about protein these days whether watching their weight or managing a disease like type 2 diabetes. However, fiber and healthy fats are nutrients many people are overlooking. The latest reports show most Americans already meet or exceed recommendations for protein while nearly all (about 95%) do not eat enough fiber, and many people consume too much saturated fat versus unsaturated fat, according to the 2025 Dietary Guidelines Advisory Committee. Prioritizing ways to get more fiber and healthy fats on your plate could be key to managing weight and type 2 diabetes goals this summer.
One food that makes it easier to invest in your health, according to nutrition experts: avocados.
A growing body of research and materials from Avocados – Love One Today, a science-based resource, suggests fresh avocados offer weight management benefits, help with type 2 diabetes management and are good for blood sugar management.
According to a study* of more than 27,000 adults published in the journal “Internal Medicine Review,” people who ate just over half of an avocado per day weighed 7.5 pounds less, had smaller waist sizes and tended to have healthier overall eating habits, including higher intakes of fiber and healthy fats, compared to people who didn’t eat avocados. Among the list of benefits, this delicious and healthy fruit uniquely contains fiber and healthy fats in each nutrient-dense bite which slows digestion, helping you feel satisfied and fuller longer which can help you consume fewer calories overall. In fact, if you’re using a GLP-1, avocados are one of the foods to add to your menu to make small meals feel more filling and satisfying while supporting nutrient needs.
Scientists also recently took a second look at the largest study* about avocado consumption to-date involving close to 1,000 adults, per the journal “Current Developments in Nutrition,” and found that consistently eating one avocado every day for six months (no other diet changes required) significantly reduced dietary glycemic load (GL) by nearly 14 points, a metric that evaluates how what you are eating is affecting your blood sugar levels. GL may be an important consideration in the management of chronic diseases like type 2 diabetes. By slowing digestion, fiber and healthy fats also support stable blood sugar levels.
There are many ways to enjoy avocados, including chopped, sliced, mashed, blended, in baked goods or even frozen. Avocados add flavor, variety and nutrition across the day.
Try these recipes for Avocado and Blueberry Chia Pudding, Avocado Breakfast Bowl with Leafy Greens for your next breakfast or snack.
*Remember: Small, consistent food choices can add up over time. Research suggests regularly eating avocados may support weight management and blood sugar targets while providing the fiber and healthy fats that many Americans are overlooking. These studies were supported by the Avocado Nutrition Center. While these findings are encouraging, the studies highlighted show an association, not cause and effect, and thus more research is needed to confirm these findings in other populations.
To explore evidence-based avocado nutrition information, along with practical tips and easy recipes, visit Avocados – Love One Today, a leading resource for avocado nutrition information.
Avocado and Blueberry Chia Pudding
- 1 1/2 cups plain, unsweetened soy milk (or milk of choice)
- 1 ripe, fresh avocado, halved, pitted and peeled
- 3/4 cup frozen blueberries
- 1/2 cup unsweetened vanilla Greek yogurt
- 1 tablespoon maple syrup
- 1/3 cup chia seeds
To Serve:
- 1/3 cup granola
- 1/3 cup fresh blueberries
- 1 kiwi, chopped
- 1/2 fresh, ripe avocado, halved, pitted, peeled and chopped
- In blender, puree soy milk, avocado, blueberries, yogurt and maple syrup until smooth. Pour mixture into storage container or bowl and add chia seeds. Whisk well to combine. Cover with lid or plastic wrap and refrigerate 4 hours or overnight, until thickened.
- To serve, divide into bowls and top with granola, fresh blueberries, kiwi and avocado.
- Notes: Use any milk (dairy or non-dairy) that you prefer in pudding. Use fresh blueberries or conventional frozen blueberries. Other topping options include: nuts, seeds, hemp hearts, sliced banana or strawberries, or nut butter.
Avocado Breakfast Bowl with Leafy Greens
Bowl:
- 1 medium sweet potato, chopped (about 1 3/4 cup)
- nonstick cooking spray
- 1/4 teaspoon smoked paprika
- 1/4 teaspoon garlic powder
- 1/4 teaspoon salt
- 1/2 cup quinoa
- 1 cup water, plus additional for boiling eggs, divided
- 2 eggs
- 2 cups arugula
- 1 ripe, fresh avocado, halved, pitted, peeled and chopped
- 1/4 cup pickled red onions
Avocado Tahini Dressing:
- 1/2 large avocado
- 1/4 cup tahini
- 1 lemon, juice only (2 tablespoons)
- 3/4 cup water
- 1 tablespoon fresh chives
- salt, to taste
- pepper, to taste
- Preheat oven to 400 F. Add chopped sweet potato to baking sheet. Spray with cooking oil then add smoked paprika, garlic powder and salt. Toss to coat in spices. Bake 22-25 minutes, or until tender.
- In medium saucepan, add quinoa and water. Bring to simmer and cover, cooking 12-15 minutes, or until quinoa is tender and fluffy.
- Fill small saucepan with water and bring to boil. Use slotted spoon to lower eggs into water. Cook 8 minutes then transfer eggs to bowl of ice water to cool before peeling.
- To make dressing: In small blender, puree avocado, tahini, lemon juice, water and fresh chives until smooth. Add more water, 1 tablespoon at a time, if needed, to thin until pourable. Season with salt and pepper, to taste.
- Assemble bowls, each with 1/2 sweet potato, 1/2 cup quinoa, 1 egg, 1 cup arugula, 1/2 avocado, 2 tablespoons pickled red onion and 3 tablespoons dressing. Reserve remaining dressing in refrigerator.
Heart-Healthy Frozen Avocado Banana Paleta
- 1 ripe, fresh avocado, halved, pitted, peeled and diced
- 4 cups orange juice
- 2 medium bananas, peeled and sliced
- 1 tablespoon lime juice
- 8 paper cups (5 ounces)
- 8 wooden craft sticks
- In blender, blend avocado, orange juice, bananas and lime juice on high until smooth. Divide into paper cups. Cover cups with aluminum foil. Insert one stick through center of each foil. Freeze 4 hours until firm.
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health and wellness
Zepbound Linked to Lower Healthcare Costs in Adults 55+ With Obesity, Real-World Study Suggests
A new real-world study of adults over age 55 with overweight or obesity found that sustained use of Zepbound (tirzepatide) for weight management was associated with lower healthcare costs over time compared with similar adults who were not treated. Eli Lilly and Company said the findings were driven in part by lower rates of hospital admissions and emergency department visits, and were published in Diabetes, Obesity and Metabolism.
What the study found
According to Lilly, researchers estimated healthcare cost differences over time (excluding the cost of Zepbound itself) using two established analytic methods. Across both approaches, monthly healthcare costs were lower, on average, among older adults who stayed on Zepbound.
Key estimates reported in the release include:
- At six months: costs were up to 15% lower (up to $181 per patient, per month).
- At 12 months: the estimated difference widened to as much as $607 per patient, per month, reflecting up to 38% lower costs than those not treated (estimates varied by model).
In the primary analysis, adults over 55 treated with Zepbound had lower rates of hospital admissions and emergency department visits across every follow-up period, along with numerically higher rates of routine outpatient and office visitsa pattern the company said was consistent with greater engagement in routine care.
Why Medicare is part of the conversation
Lilly said the cost findings may be relevant for older adults, including those in Medicares GLP-1 Bridge program. The company noted that beginning at six months, estimated healthcare savings nearly covered the programs monthly treatment cost of $195 per patient, per month, and by 12 months the estimated savings exceeded the reported monthly treatment cost.
Its important to note the release also emphasizes a limitation: claims data do not capture Zepbounds net price, and the study excluded the cost of Zepbound from total treatment costs. That means the reported differences reflect potential savings elsewhere in care that could offset treatment costs, not the full net cost impact.
Who was included in the analysis
The retrospective observational cohort study used Komodos Healthcare Map, a database of de-identified claims data from more than 330 million individuals enrolled in U.S. healthcare plans. The analysis included 15,843 adults over age 55 (mean age 64.5) with obesity or overweight plus at least one obesity-related complication who initiated Zepbound between November 2023 and September 2025. Each Zepbound user was matched 1:1 with a control participant who met the same eligibility criteria but did not initiate GLP-1 or GIP/GLP-1 receptor agonist medication.
What Zepbound is
Zepbound (tirzepatide) is a dual GIP and GLP-1 receptor agonist indicated for adults with obesity, or some adults with overweight who also have at least one weight-related medical problem, to lose weight and keep it off. Lilly also noted Zepbound is FDA-approved to treat adults with moderate-to-severe obstructive sleep apnea and obesity, and should be used alongside a reduced-calorie diet and increased physical activity.
Safety summary (high level)
The release includes an indications and safety summary with warnings. Among other risks, Lilly notes Zepbound carries a warning about thyroid tumors, including thyroid cancer, and may cause serious side effects such as severe stomach problems, dehydration leading to kidney problems, gallbladder problems, pancreatitis, serious allergic reactions, and low blood sugar (especially when used with certain diabetes medicines). Patients should talk with a healthcare provider about risks and whether the medication is appropriate for them.
Related Links
- Zepbound (official product site): https://zepbound.lilly.com/
- Lilly newsroom: https://www.lilly.com/news
- Journal page (publisher hub): https://dom-pubs.onlinelibrary.wiley.com/journal/14631326
- Medicare (official): https://www.medicare.gov/
- FDA MedWatch (side effect reporting): https://www.fda.gov/medwatch
Source
- PRNewswire / Eli Lilly and Company press release (Aug. 26, 2026): Zepbound linked to lower healthcare costs in adults over age 55 with obesity according to a real-world study
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(Feature Impact) When it comes to stroke, time matters. Recognizing the warning signs and calling 911 quickly can help with receiving time-sensitive, life-saving treatment. Recovery should begin early, too.
Having a stroke can divide life into a stark before and after, affecting many aspects of daily life. While it’s easy to focus on the things a stroke can take away, it’s important to remember there’s life after stroke. Recovery isn’t just about relearning skills. It’s about adapting to new challenges, finding purpose in a different reality and continuing to move forward.
Navigating the aftermath of a stroke means balancing short-term and long-term plans. Once medically stable, rehabilitation should ideally begin within 48 hours, according to the 2026 Guideline for Adult Stroke Rehabilitation and Recovery from the American Stroke Association. Recovery doesn’t have a fixed end. Meaningful progress can continue for months or years after survivors leave the hospital or complete formal therapy.
“Stroke rehabilitation is complicated,” said Lorie Gage Richards, Ph.D., FAHA, volunteer chair of the new guideline, associate professor at the University of Utah and an occupational therapist. “Each person faces a different set of challenges and care should be personalized to fit each person’s needs. The goal is to help individuals gain as much independence as possible to perform everyday activities while improving their overall quality of life.”
Approximately 800,000 people have a stroke each year in the U.S, according to the American Heart Association’s 2026 Heart Disease and Stroke Statistics. Whether you’re navigating recovery yourself or supporting someone you love, connecting with a coordinated healthcare team is an important first step. Ask about a comprehensive assessment, develop a rehabilitation plan based on what matters to you and set small, achievable goals throughout recovery.
Building Skills and Independence
After a stroke, familiar parts of a daily routine may take more effort or require a new approach. A rehabilitation team can assess how stroke has affected movement, communication, thinking, vision, hearing and other abilities then develop a plan based on individual needs and goals.
Recovery doesn’t look the same for everyone. For one person, a meaningful goal may be dressing independently. For others, it could be returning to work, driving safely or participating in favorite activities. Start with manageable goals, evaluate progress and reassess the plan as needs change.
Understanding the Invisible Impacts
Some of the most challenging parts of recovery may be the ones others can’t see. For instance, you might lose confidence or sense of identity, have trouble concentrating or experience anxiety or depression. Along with mental and emotional changes, you may notice ongoing physical symptoms like pain, difficulty sleeping, changes in sexual function or difficulty with bladder control.
Invisible challenges don’t have to stay that way. Ask your healthcare team to assess your physical and emotional health, including depression and anxiety, during the hospital stay and throughout recovery. Speaking up about new or changing symptoms can help identify appropriate treatment and support.
Navigating Changing Relationships
When you have a stroke, your life isn’t the only one that changes. A partner, parent or friend may suddenly take on new responsibilities, making honest conversations about support especially important.
Family responsibilities may also look different. Parenting young children, supporting loved ones or balancing work and family can bring new challenges during recovery. Give yourself permission to slow down, accept care and connect with the people who matter most.
Finding Purpose and Redefining Success
Recreation, hobbies, social connections and other meaningful activities are an important part of recovery and can help people regain confidence, participate in their communities and improve quality of life. That may mean returning to music, art, exercise or time with friends. It could also mean modifying favorite activities, discovering new interests or connecting with a support group.
Life after stroke may look different, but different doesn’t mean less meaningful. Recovery isn’t measured by how closely someone returns to who they were before. It’s about finding new ways to pursue what matters most and continuing to move forward.
Learn more about recognizing stroke, preparing for rehabilitation and adjusting to life after stroke by visiting Stroke.org.
Photos courtesy of Shutterstock
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