Women may face a heightened risk of heart attack even with lower levels of artery-clogging plaque, according to a new study by researchers at Harvard Medical School.
The study found that although women typically have less coronary plaque than men, their risk of major adverse cardiovascular events can rise at comparatively lower plaque burdens. Researchers said this challenges the assumption that lower plaque volume offers sufficient protection against heart disease in women.
Published in Circulation: Cardiovascular Imaging, the research analysed data from 4,267 outpatients experiencing chest pain but with no prior history of coronary artery disease. Of these, 2,199 were women.
The findings showed that plaque was less common in women (55 per cent) than in men (75 per cent), and total plaque volume was lower. However, overall plaque burden relative to artery size and rates of major adverse cardiovascular events were similar between the two groups.
Importantly, the study revealed that cardiovascular risk in women began to increase at a total plaque burden of 20 per cent, compared to 28 per cent in men. The risk also rose more sharply in women at lower plaque levels, while men required a higher plaque burden for a comparable increase in risk.
Researchers noted that smaller coronary arteries in women may mean even modest plaque buildup can significantly affect blood flow, suggesting that current definitions of “high risk” may underestimate heart disease risk in women.
