Lifestyle and health habits linked to heart disease may impact women more deeply than men, according to a large new study presented at the American College of Cardiology’s Annual Scientific Session (ACC.25) in March 2025.
The research shows that while women generally have better heart health profiles, they may experience a greater rise in cardiovascular risk from poor lifestyle factors compared to men with similar habits.
This study is the first to show that the combined effect of key risk factors—such as diet, exercise, smoking, blood pressure, cholesterol, and blood sugar—leads to a greater increase in heart disease risk for women than for men.
Dr. Maneesh Sud, the study’s lead author and a cardiologist at Sunnybrook Health Sciences Center in Toronto, explained, “For the same level of health, the rise in risk is higher in women than in men. It’s not one-size-fits-all.”
This finding could change how doctors assess heart disease risk in women and encourage more personalized, sex-specific approaches to prevention and screening.
What the Study Looked At
The researchers analyzed data from more than 175,000 Canadian adults who participated in the Ontario Health Study between 2009 and 2017. All participants were free of heart disease at the start. About 60% of them were women.
The study focused on eight well-known heart health factors:
- Diet
- Sleep
- Physical activity
- Smoking
- Body mass index (BMI)
- Blood glucose (sugar)
- Cholesterol (lipids)
- Blood pressure
Each participant received a score based on whether they had ideal or poor results for each factor. Researchers then grouped people into three categories:
- Ideal health: All 8 factors were in the healthy range
- Intermediate health: 5–7 healthy factors
- Poor health: Fewer than 5 healthy factors or more than 3 unhealthy ones
They tracked participants for an average of 11 years, monitoring for heart-related events such as heart attacks, strokes, chest pain, heart failure, artery-blocking procedures, and cardiovascular deaths.
What They Found
Overall, women tended to have better heart health than men:
- 9.1% of women scored a perfect 8 out of 8 (ideal health)
- Only 4.8% of men did the same
- 21.9% of women were in poor health
- But 30.5% of men fell into that category
Women were more likely to have an ideal diet, cholesterol, blood sugar, and blood pressure, while men were slightly more active.
But when it came to the impact of poor health, the consequences were more severe for women:
- Women with poor health had nearly 5 times the risk of heart disease as women with ideal health
- Men with poor health had 2.5 times the risk compared to men with ideal health
- For those with intermediate health, women had 2.3 times the risk, while men had 1.6 times the risk
This means that even if a woman and a man have the same number of unhealthy lifestyle factors, the woman’s heart disease risk increases more than the man’s.
Why Might Women Be More Affected?
The study didn’t pinpoint exactly why these differences exist, but researchers believe both biological and social factors could be at play. Women’s hearts may respond differently to stressors like high blood pressure or poor diet. Hormonal changes—particularly around menopause—could also change how risk factors impact cardiovascular health.
Dr. Sud and his team plan to look more closely at differences based on age, menopausal status, and racial and ethnic backgrounds in future analyses.
What This Means for Heart Health
These findings highlight the need for more tailored approaches to preventing heart disease, especially in women. Currently, many risk assessments and treatment plans are based on data from men or assume the same rules apply to everyone.
But as this study shows, women may need earlier or more aggressive intervention when negative risk factors are present—even if their overall lifestyle appears healthy.
For patients: This is a reminder that heart disease isn’t just a man’s issue. Women should pay close attention to their diet, exercise, sleep, blood pressure, cholesterol, and other health markers—because even small changes can have a big impact on future risk.
For doctors: Screening for heart disease in women may need to be more sensitive to their unique risk profiles. Asking about lifestyle factors and taking early action could prevent serious cardiovascular events later in life.
Final Thought
This research sends a strong message: good heart health matters for everyone, but it may matter even more for women. Understanding the gender-specific effects of lifestyle factors is key to reducing heart disease—the leading cause of death worldwide—and empowering people to take better care of their hearts.
If you care about heart health, please read studies that apple juice could benefit your heart health, and Yogurt may help lower the death risks in heart disease.
For more information about health, please see recent studies that Vitamin D deficiency can increase heart disease risk, and results showing Zinc and vitamin B6 linked to lower death risk in heart disease.
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