In a new study, researchers found that women face a 20% increased risk of developing heart failure or dying within five years after their first severe heart attack compared with men.
Previous research looking at sex differences in heart health has often focused on a recurrent heart attack or death.
However, the differences in vulnerability to heart failure between men and women after a heart attack remain unclear.
To study this gap, researchers analyzed data on more than 45,000 patients (30.8% women) hospitalized for a first heart attack between 2002-2016 in Alberta, Canada.
They focused on two types of a heart attack: a severe, life-threatening heart attack called ST-segment elevation myocardial infarction (STEMI), and a less severe type called Non-STEMI or NSTEMI, the latter of which is more common.
Patients were followed for an average of 6.2 years.
They found women were older and faced a variety of complications and more risk factors that may have put them at a greater risk for heart failure after a heart attack.
In addition to the elevated risk for heart failure among women, researchers found:
A total of 24,737 patients had a less severe form of heart attack (NSTEMI); among this group, 34.3% were women and 65.7% were men.
A total of 20,327 patients experienced STEMI, the more severe heart attack; among this group, 26.5% were women and 73.5% were men.
The development of heart failure either in the hospital or after discharge remained higher for women than men for both types of a heart attack.
Women had a higher rate of death in the hospital than men in both the STEMI and NSTEMI groups.
Women were more likely to be an average of 10 years older than men at the time of their heart attack, usually an average age of 72 years versus 61 for the men.
Women also had more complicated medical histories at the time of their heart attacks, including high blood pressure, diabetes, atrial fibrillation, and chronic obstructive pulmonary disease, risk factors that may contribute to heart failure.
Women were seen less frequently in the hospital by a cardiovascular specialist: 72.8% versus 84% for men.
Regardless of whether their heart attacks were the severe or less severe type, fewer women were prescribed medications such as beta-blockers or cholesterol-lowering drugs.
Women also had slightly lower rates of revascularization procedures to restore blood flow, such as surgical angioplasty.
The team says identifying when and how women may be at higher risk for heart failure after a heart attack can help providers develop more effective approaches for prevention.
Better adherence to reducing cholesterol, controlling high blood pressure, getting more exercise, eating a healthy diet and stopping smoking, combined with recognition of these problems earlier in life would save thousands of lives of women — and men.
One author of the study is Justin A. Ezekowitz, M.B.B.Ch., M.Sc., a cardiologist.
The study is published in Circulation.
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