Director of Public Health Annual Report 2022: Preventing heart disease and stroke in Buckinghamshire

3.3 Differences by gender

Men are more likely to have cardiovascular disease than women and more likely to die from cardiovascular disease.[125]

One in eight men and one in 15 women die from coronary heart disease.[126]

In the years before the pandemic cardiovascular disease was the leading cause of death in men.[127]

3.3.1 Inequalities in biological/clinical risk factors

Women have a lower risk of cardiovascular disease than men. However hormonal changes associated with the menopause lead to a decrease in the production of a hormone that is protective against heart disease and the risk of cardiovascular disease increases in women after the menopause. This risk increases in women that have an early menopause before the age of 40.[128]

Before the age of 65, women have a lower risk of high blood pressure but this risk reverses after the age of 65.[129]

Men aged 25-54 are twice as likely to have diabetes as women the same age.[130]

Certain pregnancy complications are associated with an increased future risk of cardiovascular disease for the mother – these include pre-eclampsia, pregnancy induced high blood pressure and gestational diabetes (the latter likely because of the increased risk of type 2 diabetes).[131]

3.3.2 Health behaviours

Men are more likely to smoke than women.[132]

Men are slightly more likely than women (62.3% vs 59.8%) to be physically active.[133] Women are slightly more likely to be inactive (27.8% vs. 26.8%) than men.[134]

Physical activity levels decreased during the pandemic for both men and women but as men’s activity levels have seen a partial recovery, women’s activity levels have remained consistently lower and may require more support to return to previous levels.[135]

A greater proportion of men (41% vs. 30%) are overweight compared to women, but a higher proportion of women (29% vs 26%) are obese compared to men in England.[136]

Being overweight or obese increases the risk of developing high blood pressure – for men this increases the risk by three times and for women by four times.[137]

Men are more likely to consume more than twice the daily limit of alcohol than women.[138] Alcohol dependence is more common in men (6%) than in women (2%) in England.[139]

3.3.3 Access to treatment

International evidence shows that women are less likely to correctly identify the symptoms of a heart attack, that they are slower to seek treatment, that they are 50% more likely to receive the wrong initial diagnosis and that when a heart attack is diagnosed, they received unequal care.[140] Prompt treatment is critical to reduce complications and damage after a heart attack.