Risk factors and complications differ for women and men. Women who have gone through menopause have decreased levels of estrogen production, while estrogen has been shown to lower the risk of heart disease. For this reason, many women without a history of breast cancer choose hormone replacement therapy, weighing its benefits over its potential risks. For women with a history of breast cancer hormone replacement therapy may not be a choice. For these women it is essential that they manage their risk for heart disease by closely monitoring the other known risk factors.
Smoking is known to bring on menopause more quickly, and have an antiestrogenic effect on women.
Again, this undermines the protective qualities of estrogen in regards to heart disease. Women who are smokers and are on oral contraceptives greatly increase their risk for heart disease. Furthermore, women who are diabetics are more likely to suffer from obesity which presents additional risk. Women are not only at risk for heart disease for different reasons than men, they also show a different set of symptoms. But women not only show heart disease differently, they also are far more likely to have complications associated with a heart attack, such as shock or heart failure.