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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Three new studies shared this week at the Society of NeuroInterventional Surgery (SNIS) 23rd Annual Meeting deliver a clear message: stroke care in the U.S. is improving, but those gains are not reaching everyone equally. Researchers found persistent disparities tied to race, geography, and socioeconomic status—factors that can shape whether a patient receives advanced treatment, how quickly they reach specialized care, and ultimately, whether they survive.
Stroke remains one of the nation’s leading causes of death and long-term disability. In recent years, breakthroughs in emergency response systems and minimally invasive procedures have expanded what’s possible in the critical first hours after a stroke. But the latest findings suggest that access to those life-saving advances still depends too heavily on who you are and where you live.
Study 1: Treatment gaps widen as strokes get more severe
The first study, “Racial Disparities in Endovascular Thrombectomy Widen with Stroke Severity: A National Inpatient Sample Analysis,” examined more than 325,000 acute ischemic stroke patients treated at U.S. teaching hospitals between 2018 and 2022.
The focus was endovascular thrombectomy (EVT), a minimally invasive procedure in which specialists remove a clot from a blocked artery in the brain. EVT can be a game-changer for eligible patients—but researchers found Black patients were less likely than white patients to receive it across all levels of stroke severity.
What stood out most: the disparity grew as stroke severity increased. At a National Institutes of Health Stroke Scale (NIHSS) score of 20, the predicted probability of receiving EVT was:
- 33% for white men
- 32% for white women
- 28% for Black men
- 26% for Black women
Co-first author Muhammed Amir Essibayi, MD, MSc, FRCP, noted that timely access becomes even more critical as severity rises—yet the treatment gap becomes more pronounced. The study also highlighted an intersectional pattern, with Black women consistently least likely to receive EVT.
Study 2: Hemorrhagic stroke deaths are falling—but disparities persist
The second study, “Reducing Inequalities in Stroke Events-Hemorrhagic Disparities (RISE-HD): A 10-year Statewide Analysis of Social Determinants of Mortality in Hemorrhagic Stroke,” analyzed more than 120,000 patients hospitalized with hemorrhagic stroke in Florida between 2013 and 2024.
There was good news: mortality rates declined significantly over the decade, suggesting real progress in stroke systems and hospital care.
But after adjusting for age, sex, and comorbidities, disparities remained. Black patients had higher odds of in-hospital mortality than white patients. Higher mortality was also associated with:
- Living in rural areas
- Having Medicaid or other non-commercial insurance
Researchers also found regional differences across Florida, pointing to uneven access to specialized stroke care.
Primary author Natália Vasconcellos, MD, MSc, emphasized that improving outcomes for everyone will require addressing barriers to specialized stroke systems—especially in underserved communities.
Study 3: The “Stroke Belt” has two different access problems
The third study, “Dual Pathways to Hemorrhagic Stroke Mortality Across the U.S. Stroke Belt: Rural Neurointerventional Isolation and Urban Structural Vulnerability,” looked at hemorrhagic stroke mortality across 433 counties in the “Stroke Belt,” a region long associated with higher stroke rates and worse outcomes.
Researchers compared factors linked to mortality in rural versus urban counties, including:
- Distance to the nearest Comprehensive Stroke Center
- Community-level socioeconomic disadvantage
- Racial and economic segregation
- HIV burden
They found the drivers of mortality differed sharply by setting:
- In rural counties, longer travel times to Comprehensive Stroke Centers were more strongly associated with higher mortality.
- In urban counties, racialized economic segregation and HIV burden were more strongly associated with poorer outcomes—even when specialized care was geographically closer.
Dylan Yates, a medical student at Tulane University School of Medicine, summarized the takeaway: the neurointerventional access gap in the Stroke Belt is “not one problem, it is two.” Solutions need to match the reality on the ground—strengthening transfer networks and specialty connections in rural areas, while addressing structural disadvantage and underinvestment in urban communities.
What to watch for: where the system can improve
Across all three studies, the common thread is that medical innovation alone doesn’t guarantee equitable outcomes. Researchers pointed toward targeted interventions that could help close the gap, including:
- More consistent, equitable treatment pathways for advanced stroke procedures like EVT
- Stronger stroke transfer networks to reduce delays—especially in rural regions
- Expanded access to specialty stroke care and Comprehensive Stroke Centers
- Community-level investment and structural reforms in underserved urban neighborhoods
For patients and families, these findings also reinforce the importance of recognizing stroke symptoms quickly and calling 911 immediately. Time is brain—yet the system must ensure that “time” and “access” don’t vary based on race, ZIP code, or insurance status.Source: Society of NeuroInterventional Surgery (SNIS), July
Related Links
- Society of NeuroInterventional Surgery (SNIS) — https://www.snisonline.org
- NIH: Stroke (overview, symptoms, treatment) — https://www.ninds.nih.gov/health-information/disorders/stroke
- CDC: Stroke (risk factors, prevention, data) — https://www.cdc.gov/stroke/
- American Stroke Association (ASA): Stroke resources — https://www.stroke.org/
- NIH Stroke Scale (NIHSS) basics (clinical context) — https://www.stroke.nih.gov/resources/scale.htm
- Find a certified stroke center (The Joint Commission) — https://www.qualitycheck.org/
SOURCE Society of NeuroInterventional Surgery
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Family
Teach and Inspire Your Kids by Exploring History as a Family
History as a Family: During back-to-school season, education is naturally at the forefront of most parents’ minds. While a lot of important learning is accomplished in the classroom, there are so many opportunities to continue challenging and developing children’s minds and hearts in family life as well.
Teach and Inspire Your Kids by Exploring History as a Family
(Feature Impact) During back-to-school season, education is naturally at the forefront of most parents’ minds. While a lot of important learning is accomplished in the classroom, there are so many opportunities to continue challenging and developing children’s minds and hearts in family life as well. Learning about history together is a practical way to inspire deep, meaningful conversations about the world, whether from books, documentaries or visits to museums.
Watch this video to learn more
Now is an opportune time to explore the story of Anne Frank, a Jewish teenager evading Nazi capture during the Holocaust. Families can read her famous diary together then visit “Anne Frank The Exhibition,” presented by the Anne Frank House at the Griffin Museum of Science and Industry. This comprehensive exhibition immerses visitors in the context that shaped Frank’s life, from her early years in Frankfurt through her tragic death and how her father ensured her legacy. The centerpiece is the first full-scale recreation of the Annex where the Frank family and four other Jews hid during the Nazi occupation of the Netherlands. The exhibition, recommended for visitors ages 10 and older, is open through early 2027.
No matter what piece of history families choose to delve into together, they should take the time to discuss with their kids what they’re thinking and feeling about everything they’re discovering. Then together they can figure out what lessons from the past can be taken into the future.
“Anne Frank ’s story is a powerful reminder of what happens when fear and hatred are
allowed to take root,” said Dr. Chevy Humphrey, Griffin Museum of Science and Industry
president and CEO. “At the same time, it reveals the quiet but enduring strength of
curiosity, creativity and resilience, values that sit at the heart of our mission. We hope this
exhibition offers meaningful moments of reflection for our guests, particularly young
people, and encourages them to think critically about their role in the world they are
inheriting.”
Learn more about the exhibit and other experiences that bring history and science to life at GriffinMSI.org.
SOURCE:
Griffin Museum of Science and Industry
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Lifestyle
If You’re Feeling Stressed by Pricey Meds, Pharmacists Can Help
Stressed by Pricey Meds? If your wallet is feeling the squeeze of prescription drug costs as other living expenses like grocery and energy prices rise, you’re not alone. That’s where a powerful ally can help you manage drug costs: a health-system pharmacist.
If You’re Feeling Stressed by Pricey Meds, Pharmacists Can Help
(Feature Impact) If your wallet is feeling the squeeze of prescription drug costs as other living expenses like grocery and energy prices rise, you’re not alone.
More people are worrying about affording essential medications these days. In fact, more than 40% of adults said they skipped doses or didn’t fill prescriptions in the past year due to cost, according to a KFF Health survey.
People who take multiple drugs to manage chronic conditions often feel this pinch even more severely. They’re also more likely to make more frequent visits to their clinic or health system for care. That’s where a powerful ally can help them manage their drug costs: a health-system pharmacist.
These medication experts work side-by-side with the clinicians who prescribe drugs in health care practices – and sometimes prescribe medications themselves. Their deep knowledge can help people get the most out of the drugs they take.
“Pharmacists really know the full picture of medications, including pricing, insurance coverage, alternative therapies and potential side effects,” said Lindsey Amerine, PharmD, chief pharmacy officer for the Cleveland Clinic. “That’s why it’s helpful to not only count on your doctor to diagnose your condition and prescribe therapies, but also your pharmacist to optimize your medications.”
Get a Comprehensive Review of Your Medications
Asking the pharmacist on your health-system care team to go over your medications may reveal opportunities to save, Amerine said. Health-system pharmacists are uniquely qualified to provide this service because they keep close track of medication costs as well as approvals of new drugs and how those compare to older options.
A full review might reveal:
- Drugs once needed may not be as useful anymore. People often continue taking medications unaware that something new could offer greater benefits or their condition no longer requires the same therapy.
- Changes in your condition may mean you could safely take a lower dosage of a drug, thereby reducing costs.
- There may be less costly alternatives that would work as well such as a generic or older medication.
Get Help Exploring Discount Options
You’ve probably heard about programs that can help lower prescription costs, including discount and patient assistance programs. Pharmacists can help you understand how to navigate these programs and access potential discount programs and opportunities, Amerine said. Here’s how:
- Pharmacists can guide you through discount programs your health system offers.
- They can check your eligibility for drug maker discounts and help you understand how those discounts work with your insurance, especially if you have a high-deductible plan.
- Pharmacists can help you navigate the various prescription cost-savings programs and how they work.
- They can also help you learn about patient assistance programs that provide free or discounted medications to people who cannot afford them.
Medications are a vital part of your health care. Before you try to stretch a costly medicine or give it up altogether, talk to the medication expert on your health care team: your health-system pharmacist. For more information, visit yourpharmacist.org.
Why It Pays to Talk Meds with a Pharmacist
“My doctor prescribed it, so I must need it.” Often this is true, but not always. People sometimes take drugs longer than they need to, at doses higher than necessary or that may interact with other medications.
Just as you’d see a heart specialist about an odd pulse rate, it can help to see a pharmacist – your medication specialist – to discuss your prescriptions.
Of all health care professionals, pharmacists have the deepest knowledge of drug interactions and safety issues. They’re experts on how the effectiveness of different medications – brand name and generic – compare. They also closely track changes in prices and know when a drug’s cost has dropped or if an effective, less costly alternative is available.
Health-system pharmacists’ expertise is especially helpful for those with multiple chronic conditions who typically take several medications with more benefits, costs and side effects to balance.
Talking with a pharmacist can ensure your prescriptions are best for you and that you have access to the most affordable options.
SOURCE:
American Society of Health-System Pharmacists
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