Myth #2

Men and women’s hearts age equally.

False, this may not be true!
There is evidence that as we age, women’s hearts have to work harder than men’s hearts, and this seems to be due to 2 main reasons - Hormones and the Bodily Differences between men and women!

Hormones at work!

Oestrogen is a hormone produced by women and is linked to their reproductive system and female characteristics. Additionally, oestrogen acts like a shield that blocks the heart from dangerous attacks by various hazards. Also, oestrogen is like an energy drink that boosts the heart and increases blood flow to the rest of the body.

On the other hand, men have the hormones androgens and testosterone which maintain male characteristics. Androgens are also like boosters which promote enlargement of skeletal muscle mass by signaling myoblasts to differentiate into muscle cells. This explains why men generally have more muscle mass than women. Bigger skeletal muscles means they need more energy as well! Thus, men’s hearts have to work extra hard to supply blood to them.

Coupled with testosterone, this is generally why there is a larger cardiac muscle mass in men.

Biological differences!

Furthermore, men’s hearts have generally been found to have larger left ventricles regardless of age!

An increase in muscle mass means that the cardiac muscle cells demand more oxygen and nutrients. As the heart is already efficient in extracting oxygen from blood, an increased oxygen demand can only be met with an increased blood flow in the coronary arteries.

Supply of insufficient blood to the cardiac muscles can cause cardiac ischemia and angina pectoris (more commonly known as chest pain) (see Myth #1).

Thus, men generally have biologically older hearts and are more prone to various cardiac illnesses.

BUT women’s hearts age faster!

After menopause, oestrogen is no longer produced in such a large amount, removing the heart’s ‘shield’ and ‘energy drink’. Without these power-ups, women’s hearts now have to work harder and are also prone to attacks they were once safe from. It has thus been observed that in postmenopausal women, the left ventricles of their hearts have increased mass, become stiffer and less stretchy. These are all related to signs of an ageing heart.

Therefore, for postmenopausal women, their hearts start to age faster than men!

Why is this important?

“The concept that heart disease may have different pathophysiology in men and women and of the need for tailored treatments that address such important biologic differences” says Dr. Joao Lima, professor of medicine and radiological science at the Johns Hopkins University School of Medicine and director of cardiovascular imaging at its Heart and Vascular Institute.

The increased thickness of heart ventricles and decrease in size of heart chambers raise the risk of heart failure in men with age. These gender-related differences may mean that men and women develop diseases for different reasons. Oestrogen withdrawal with menopause in women also poses a problem of heart failure. Thus, understanding of these differences can allow us to understand the manifestations and progression of cardiovascular diseases in men and women.

Furthermore, knowledge of these hormonal differences contributes to the studies of possible hormonal therapy to counter heart diseases.

Through an MRI scan, taking account of these physiological differences in the hearts of men and women can also help to cater more specific treatments for different people and also ways to ease the transition from pre to post menopause in women.

Written by: Ng Hong Jie

References

Male and Female Hearts Don’t Grow Old the Same Way - 10/20/2015. (2015). JOHN HOPKINS MEDICINE. https://www.hopkinsmedicine.org/news/media/releases/male_and_female_hearts_dont_grow_old_the_same_way
Merz, A. A., & Cheng, S. (2016). Sex differences in cardiovascular ageing. Heart, 102(11), 825–831. https://doi.org/10.1136/heartjnl-2015-308769
Olivetti, G., Giordano, G., Corradi, D., Melissari, M., Lagrasta, C., Gambert, S. R., & Anversa, P. (1995). Gender differences and aging: Effects on the human heart. Journal of the American College of Cardiology, 26(4), 1068–1079. https://doi.org/10.1016/0735-1097(95)00282-8
Sinha-Hikim, I., Taylor, W. E., Gonzalez-Cadavid, N. F., Zheng, W., & Bhasin, S. (2004). Androgen Receptor in Human Skeletal Muscle and Cultured Muscle Satellite Cells: Up-Regulation by Androgen Treatment. The Journal of Clinical Endocrinology & Metabolism, 89(10), 5245–5255. https://doi.org/10.1210/jc.2004-0084
Stice, J. P., Lee, J. S., Pechenino, A. S., & Knowlton, A. A. (2009). Estrogen, aging and the cardiovascular system. Future Cardiology, 5(1), 93–103. https://doi.org/10.2217/14796678.5.1.93

Myth #2

Men and women’s hearts age equally.

False, this may not be true! There is evidence that as we age, women’s hearts have to work harder than men’s hearts, and this seems to be due to 2 main reasons - Hormones and the Bodily Differences between men and women!

False, this may not be true!
There is evidence that as we age, women’s hearts have to work harder than men’s hearts, and this seems to be due to 2 main reasons - Hormones and the Bodily Differences between men and women!