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Women not protected from heart attacks despite lower plaque levels, study finds
Women are not protected from heart attack even though they usually have less artery plaque than men, according to a study of more than 4,200 adults.
Researchers found that heart attack and chest pain risk in women began at lower levels of artery plaque, the fatty material that builds up inside blood vessels and can restrict blood flow to the heart.
Risk also increased more rapidly in women than in men, particularly after menopause.
The research was carried out by scientists at Harvard Medical School and Massachusetts General Hospital in Boston.
Borek Foldyna, assistant professor in radiology at Harvard Medical School, said: “Our findings underscore that women are not ‘protected’ from coronary events despite having lower plaque volumes.
“Because women have smaller coronary arteries, a small amount of plaque can have a bigger impact.
“Moderate increases in plaque burden appear to have disproportionate risk in women, suggesting that standard definitions of high risk may underestimate risk in women.”
The study analysed health data from more than 4,200 adults with stable chest pain and no previous coronary artery disease.
Participants underwent diagnostic evaluation using coronary computed tomography angiography, a specialised X-ray scan of the heart’s arteries, and were followed for about two years.
Fewer women had plaque in their coronary arteries than men, with plaque present in 55 per cent of women compared with 75 per cent of men.
Women also had a lower overall plaque volume. Despite this, women were nearly as likely as men to die from any cause, have a non-fatal heart attack or be hospitalised for chest pain.
The analysis showed that women’s risk began to rise when plaque burden reached 20 per cent, compared with 28 per cent in men. As plaque levels increased, risk rose more sharply in women.
Heart disease is the leading cause of illness and death in the US and worldwide, according to the American Heart Association.
Cardiovascular disease was responsible for 433,254 deaths among females of all ages in the US, accounting for 47.3 per cent of deaths from the condition.
Stacey E. Rosen is volunteer president of the American Heart Association and executive director of the Katz Institute for Women’s Health at Northwell Health in New York City.
She said: “These findings are another important example of why it is imperative to recognise that cardiovascular disease can impact men and women so differently.
“There is an overdue recognition of fundamental, biological differences in the way health conditions manifest in women versus men, and these differences can influence everything from risk factors to symptoms to treatment response.
“I’m heartened to see more research such as this emerging as we address ways to reduce cardiovascular disease burden among all people.”
Apple announced menopause and perimenopause tracking for its Health app at WWDC 2026, with symptom logging and cycle alerts for some users.
The update expands the app’s cycle tracking beyond fertility and menstrual periods.
If logged cycle patterns suggest a user may be experiencing perimenopause, the app will send a notification prompting a conversation with a doctor.
However, this perimenopause-specific cycle deviation notification is only for users aged 40 and over and is not intended to replace a doctor’s diagnosis or treatment.
Stacey Ford, Apple’s vice-president of OS management, said users will also be able to log menopause and perimenopause symptoms in the Health app.
Educational content will also be available to help users learn more about these life stages and understand changes in their bodies.
Every year, about 2 million women enter perimenopause, the stage before menopause when levels of the hormone oestrogen decline.
According to a February 2025 survey involving 4,432 participants aged over 30, more than half of women aged 30 to 35 experienced moderate or severe perimenopause symptoms.
The findings suggest perimenopause does not affect only older adults.
About 6,000 women in the US enter menopause every day, according to the Society for Women’s Health Research.
Given the number of women affected by perimenopause and menopause, the update broadens the Health app’s scope.
The app launched in 2019, meaning it has gone seven years without these women’s health tracking features, which could help users better understand their bodies and prepare for informed conversations with doctors.
A £50m maternity consortium will bring together UK clinicians, researchers and communities to tackle the most critical gaps in maternal care.
Funding from the National Institute for Health and Care Research has established the NIHR Inequalities Challenge: Maternity Disparities Consortium under the leadership of the University of Birmingham and Newcastle University.
Higher education bodies, NHS organisations, community groups and voluntary organisations from across the UK will work together through the programme.
The NIHR has committed £50m over five years to support research led by clinicians, researchers and communities across the consortium.
Professor Joht Singh Chandan, consortium co-lead for research at the University of Birmingham, said: “National attention on maternity safety and equity has never been greater, but ambition must now be matched by evidence and implementation.
“Through this consortium, we will work across the UK to understand what works, for whom and in what contexts, and to ensure that research leads to practical changes in care for the women, babies and families who need them most.”
The launch comes at a pivotal moment for UK maternity care, with growing national attention on improving safety, equity and women’s experiences of care.
The government’s renewed Women’s Health Strategy highlights the need to improve care before and between pregnancies for underserved communities.
Against that backdrop, the consortium will generate the evidence, interventions and research capacity needed to help turn national ambition into practical improvements for women, babies and families.
University of Birmingham is leading work to improve maternity care pathways across the antenatal, intrapartum and postnatal periods.
Antenatal care covers pregnancy before labour, while intrapartum care refers to care during labour and birth.
The consortium will examine how women and families can be better supported before pregnancy and between pregnancies.
This includes improving access to advice and care that can help people prepare for pregnancy, manage existing health conditions and reduce risks before they build up.
Other research will focus on improving care during pregnancy, birth and the early weeks after birth.
This will include work on major causes of poor maternal health, such as high blood pressure, diabetes in pregnancy, obesity, perinatal mental health and complications during recovery after birth.
Professor Judith Rankin OBE, consortium co-lead for research and capacity development at Newcastle University, said: “This funding represents a critical opportunity to make the step change we need to improve outcomes for women and their babies.
“Alongside the research, the Consortium will be investing in tomorrow’s research leaders today to ensure we have the capacity to deliver on improving pregnancy outcomes, access to, and experience of, care.”
Peers have called for law reform after two House of Lords debates on fertility treatment, surrogacy, embryo research and declining birthrates.
The first debate was put forward by crossbench peer Baroness Ruth Deech, who previously chaired the UK’s fertility regulator, the Human Fertilisation and Embryology Authority.
She discussed proposals from the HFEA to reform the Human Fertilisation and Embryology Act, along with proposals from the Scottish Law Commission and the Law Commission of England and Wales to reform the Surrogacy Arrangements Act.
She called for parliamentary scrutiny of possible changes to regulatory powers, consent rules, donor information and future scientific developments.
Baroness Deech said: “Parliament should plan by setting up a Select Committee to examine the HFEA’s proposals to expand regulatory powers, simplify consent rules, modernise donor information provisions and create a flexible framework for future scientific developments.”
Former fertility professionals were among those contributing to the debate.
Professor Lord Robert Winston, a Labour peer who founded the IVF service at Hammersmith Hospital in London, said: “Infertility is not a disease; it is actually a symptom of something wrong.”
Professor Baroness Geeta Nargund, a Labour peer, current HFEA member and former medical director of CREATE Fertility, disagreed.
She said: “Infertility is a disease, as stated by the World Health Organisation.”
Liberal Democrat peer Baroness Caroline Pidgeon highlighted regional differences in access to NHS-funded fertility treatment.
She cited figures from the Progress Educational Trust’s NHS Fertility Funding Tracker showing that only two of England’s 42 integrated care boards comply with the recently updated fertility guideline published by the National Institute for Health and Care Excellence.
Integrated care boards are local NHS organisations responsible for planning and funding healthcare services in their areas.
Baroness Pidgeon said many boards were offering only a partial IVF cycle rather than a full cycle as defined by NICE.
A full IVF cycle generally includes ovarian stimulation, egg collection and the transfer of all suitable fresh and frozen embryos created during treatment.
Crossbench peer Professor Baroness Clare Gerada, a former president of the Royal College of General Practitioners, said: “The proportion of NHS-funded IVF cycles has fallen to just under 30 per cent, the lowest level since 2008.”
She added that, in relation to IVF, “the NHS system has collapsed”.
Liberal Democrat peer Lord Monroe Palmer said it was “very ironic that it is difficult for many patients to access publicly funded fertility treatment in the very country where IVF was originally pioneered”.
Conservative peer Edward Howard, Earl of Effingham, also raised concerns about the NICE fertility guideline.
He said: “Access remains highly variable across England, because ICBs are not required to implement that guidance.”
He described the situation as “a clear gap between guidance and enforceable entitlement”.
Baroness Deech called for “automatic record sharing between clinics and the NHS central records system”.
Baroness Nargund supported this and linked the ambition to the Single Patient Record in the government’s Ten-Year Health Plan for England and the Health Bill currently before Parliament.
Baroness Pidgeon said such ambitions were at odds with the exceptional degree of medical secrecy that currently applies to IVF.
She also pointed to “a clear desire for the HFEA to be able to permit patients to give generic consent for the use of their embryos in research”.
Patients cannot currently give broad consent for unspecified future research involving their embryos.
Responding for the government, Labour peer Baroness Judith Blake said “immediate legislative reform” was not possible because “the legislative programme for this Parliamentary session is very full”.
Baroness Deech replied: “It might well take some years, but the Government really needs to set up that Select Committee and do the legislative scrutiny right now.”
A second debate on related issues followed immediately afterwards.
Baroness Nargund asked the government “what assessment they have made of the UK’s declining birthrates in an ageing population”.
She also said: “We still have a postcode lottery for IVF provision, with nearly 70 per cent of ICBs funding only one cycle of treatment.”
Responding for the government, Labour peer Lord Philip Wilson said: “The Government are committed to improving fair and equitable access to fertility services, recognising the significant emotional and health impacts of infertility.”
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