CLAIM: 

Heart Diseases are directly connected to the sex of a person, with females being at lower risk.

FACT: 

Largely true; while it is true that heart disease is more prevalent in men than women, there are some nuances that should not be ignored either. 

First Check came across a video on YouTube titled “Big R*SK for MEN” with claims ranging from how men are at a higher risk of dying from heart disease to why women who had more number children were protected from heart disease. The video features Dr Bimal Chhajer, in conversation with podcaster Gaurav Thakur. 

In the video, when the anchor says that, on an average, men have more heart attacks than women, Dr Chhajer responds that “out of 10 (heart patients), 9 would be male and 1 would be female.”

“Male’s heart issues would start at 20 and by 50 they would become a heart patient. In females, As long as they continue to menstruate and the effect of hormones remains; the blockage does not occur. Males are at a disadvantage because of a lack of these hormones,” Dr Chhajer says in the  less-than-a-minute long video clip, which was shared by a YouTube channel called The Gaurav Thakur Show Clips with close to 90 lakh subscribers and has over 44,000 views. It appears to be cut from a longer, almost two hour long, podcast episode of the “The Gaurav Thakur Show,” which has close to 38 lakh views on YouTube.

However, he says that with the changing lifestyles of women, including unhealthy diets and lack of exercise, the gap has reduced to about three women for every seven men. 

“In a single menstrual period 10-12 ova would be released out of which one would mature. Now when a woman gets pregnant, ‘ova loss’ would stop for 12 months. Earlier, women had around 10 kids each, which meant that 10 years’ worth of her ova were saved. Their periods would only stop at the age of 60, so their chances of heart disease were very less,” says Dr Chhajer, while adding that women are having fewer children now and that is also a reason for women hitting menopause at younger ages now and in turn, getting heart disease at an earlier age. 

But is this true? 

The first claim here is that there is a gender difference in the incidence of heart disease, with men about two to nine times more likely to have heart disease. 

There is some credence to these claims. A study in the British Medical Journal from 2017 says that “men generally develop CVD (cardiovascular disease) at a younger age and have a higher risk of coronary heart disease (CHD) than women,” while adding that women are at a higher risk for stroke.  

In India too it is more common in men than women, though an exact ratio has not been mentioned. This studyfrom India states, “Men have a higher burden of premature mortality in terms of Years of life lost (YLL) due to CVD than women in India, with pronounced differences at adult ages of 50–54 years and over.”

However, at least some part of this could have to do with pedagogical biases against women. For instance, 2010 review says “the risk of heart disease in women is often underestimated due to the misperception that females are ‘protected’ against cardiovascular disease.”

In fact, in 2023, it was reported that “women are more than twice as likely to die after a heart attack than men, according to research presented today at Heart Failure 2023, a scientific congress of the European Society of Cardiology (ESC).” 

Harvard Health Publishing, published an article in 2022, highlighting that while it is true that prevalence of heart disease is lower among women, it is also true that “gender — which refers to the social and cultural characteristics associated with being male or female — has contributed to disparities in cardiovascular care.” 

The claim that men’s heart issues begin in their 20s, also seems to be an oversimplification. According to the National Lipid Association, “The lifetime risk of developing CHD by age 40 is about 50% for men and 33% for women, but incidence and mortality generally lag by a decade in women.” 

Research also corroborates that hormones in women also protect them from heart disease to a great extent. A study from 2022 highlights that “women develop heart diseases later than men because of the protection in the reproductive phase of their life. Once they enter menopause the risk increases. Estrogen provides a protective effect against heart disease in women. Therefore, the risk of CVD increases after menopause in most cases.”

However, we could not find any evidence to suggest that women bearing fewer children was in any way contributing to an increased prevalence of heart disease among them. In fact, in 2019, it was said that “using medical record and survey data collected from more than 3,400 women, Johns Hopkins Medicine researchers have added to evidence that women who have given birth five or more times were more likely than those who had fewer births to have more risk factors for heart disease, including obesity, high blood pressure and inadequate physical activity.” It however, also clarifies that they do not “suggest a cause and effect relationship between pregnancy itself and heart disease,” but rather that mothers with more children may have less time to take care of themselves.