New research out of the University of Oxford, UK, has found another difference between heart disease in men and women, this time regarding risk factors: While smoking, diabetes and high blood pressure increase the risk of a heart attack in men, they increase the risk more in women.

Heart disease is the leading cause of death among Indian women and men.

“Overall, more men experience heart attacks than women. However, several major risk factors increase the risk in women more than they increase the risk in men, so women with these factors experience a relative disadvantage,” said Elizabeth Millett, PhD, an epidemiologist at Oxford’s The George Institute for Global Health who led the research using data from the UK’s Biobank.

In essence, the exact same behaviors are more dangerous for women than for men.

The study of 472,000 participants aged 40-69, found that smoking, diabetes, high blood pressure and having a BMI >25 puts both men and women at increased risk of having a heart attack. However, the risk of having a heart attack within the male and female populations who exhibit the same so-called ‘risk factors,’ was very different. Women carried a higher excess risk when they had one or more of the risk factors. This means that, for example, while a male who smokes, for example, has a two times higher risk of heart attack than a man who doesn’t smoke, a woman who smokes has three times higher risk of a heart attack than a woman who never smoked.

This same excess risk was also found among women with high blood pressure, and Type I and Type II diabetes (though not those with a high BMI). More specifically:

• Excess risk of heart attack among women smoking 20 or more cigarettes per day when compared with people who those who never smoked, was twice as big in women as in men;
• High blood pressure was associated with a more than 80% higher relative risk in women than in men;
• Type I diabetes was associated with an almost three times higher relative risk in women than in men; and
• Type II diabetes carried a 47% higher relative risk in women than in men.

Researchers also looked at the risk of heart attack associated with aging. While the increase in risk posed by factors such as smoking and high blood pressure lessened in both sexes as they grew older, the additional excess risk experienced by women was found to persist with aging.

These findings are particularly important for an Indian population, where incidence of heart disease is likely to continue to rise due to lifestyle factors. Women in India struggle, due to diet and lifestyle factors, with both high blood pressure and diabetes at increasing rates. If those diagnoses by themselves weren’t reason enough to make lifestyle changes such as diet and exercise, perhaps the increased risk of fatal diseases like heart disease will be.