Women’s Heart Attack Risk: Lower Plaque Levels Than Men | Cardiology News

Cardiovascular diseases remain the leading cause of illness and death globally. A new study reveals that women may face significant heart risks even with less arterial plaque buildup than men, challenging previous assumptions about cardiovascular health disparities.

Understanding the New Findings

Published on Monday in Circulation: Cardiovascular Imaging, the research analyzed medical information from over 4,200 adults, more than half of whom were women. All participants experienced stable chest pain but had no prior history of coronary artery disease. They underwent cardiac CT angiography – an imaging technique using X-rays to visualize the heart and blood vessels – and were monitored for approximately two years.

Did You Know? According to the study, women experienced a heightened risk of cardiovascular events beginning with as little as 20% arterial narrowing, compared to 28% for men.

The analysis showed that 55% of women had plaque in their coronary arteries, compared to 75% of men. The median plaque volume was smaller in women – 78 mm3 – versus 156 mm3 in men.

Disproportionate Risk for Women

Despite having less plaque, women experienced a similar probability of death from any cause, non-fatal heart attack, or hospitalization for chest pain as men: 2.3% compared to 3.4%. As plaque volume increased, the risk escalated more sharply for women than for men.

Expert Insight: The study suggests that standard risk assessments may underestimate the true cardiovascular risk for women, given their typically smaller coronary arteries and the disproportionate impact of even moderate plaque buildup.

Dr. Borek Foldyna, lead author of the study, a physician and scientist at Harvard Medical School, explained, “Our results show that women are not ‘protected’ from coronary events, even if they have a smaller volume of plaque in their arteries. Because women have smaller coronary arteries, a small amount of buildup can have a greater impact.”

Implications and Future Considerations

Experts emphasize that cardiovascular disease affects men and women differently. Biological differences can influence risk factors, symptoms, and treatment responses. recognising these distinctions is crucial for reducing the burden of cardiovascular disease.

According to a 2026 report from the American Heart Association (AHA) on cardiovascular disease and stroke, these conditions were responsible for the deaths of 433,254 women of all ages in the United States, representing 47.3% of all deaths attributed to these conditions.

Further research could focus on refining risk assessment tools to better account for sex-specific differences in cardiovascular anatomy and physiology. We see also possible that increased awareness of these disparities will lead to earlier and more targeted interventions for women at risk. A possible next step could be to investigate the impact of hormonal changes, particularly after menopause, on the progression of plaque buildup and cardiovascular risk in women.

Frequently Asked Questions

What did the study examine?

The study analyzed data from over 4,200 adults with stable chest pain and no prior coronary artery disease, using cardiac CT angiography to assess plaque buildup and tracking outcomes for approximately two years.

Did the study find any differences between men and women?

Yes, the study found that women generally had less plaque in their arteries than men, but experienced a similar risk of adverse cardiovascular events, and that risk increased more rapidly with even small amounts of plaque buildup.

What does Dr. Foldyna suggest about current risk assessments?

Dr. Foldyna suggests that current risk assessments may underestimate the risk for women because of their smaller coronary arteries, meaning even moderate plaque buildup can have a significant impact.

How might a better understanding of these differences impact cardiovascular care for women?