Why are cardiovascular diseases often misperceived as a male-only illness?

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Cardiovascular Diseases Are Not Exclusively a Male Illness

Cardiovascular diseases (CVDs) are frequently misperceived as a male-only condition due to men generally developing these conditions at younger ages and women experiencing biological protection during their reproductive years. However, this perception overlooks several factors that contribute to CVD risk in women, including hormonal changes post-menopause, specific female health issues, and differences in symptom presentation.
Estrogen Provides Protection During Reproductive Years

Women of reproductive age are largely shielded from atherosclerotic cardiovascular disease (ASCVD) due to the regulatory influence of estrogen on their cardiovascular system. This hormonal protection contributes to a lower incidence of cardiovascular events in younger women compared to their male counterparts. However, this protective effect diminishes significantly after menopause.
Post-Menopause and Unique Risk Factors Increase Risk

The average age of menopause for Malaysian women is around 50.7 years, and the subsequent sharp decline in estrogen levels significantly elevates their risk of CVD. Beyond hormonal shifts, women face unique and emerging risk factors for ASCVD. These include premature menopause, complications during pregnancy such as preterm birth, pregnancy-induced hypertension, and gestational diabetes mellitus, as well as treatments for breast cancer. These factors can individually or collectively predispose women to a higher likelihood of developing CVD.
Autoimmune Diseases and Symptom Presentation Complicate Diagnosis

Young women are disproportionately affected by autoimmune diseases, including rheumatoid arthritis, systemic lupus erythematosus, and Sjögren's syndrome. These conditions are associated with an increased risk of developing CVD compared to similarly aged men. Furthermore, women often report a wider array of symptoms for CVD, including more than three non-chest pain related symptoms, which can make initial diagnosis, particularly for myocardial infarction, more challenging for physicians. This can lead to delayed or inadequate treatment intensification, resulting in higher rates of hospital readmission and mortality from CVD.

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Why are cardiovascular diseases often misperceived as a male-only illness?

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