However, heart disease in women is different than in men, apparently because nature designed it that way. The protection earlier in life appears to be the presence of estrogen, the hormone that not only controls much of a woman's reproductive life but apparently is involved in many other functions as well. A key issue in treating heart disease in women is the decision about whether to use estrogen replacement therapy. The question is not an easy one for either physicians or women themselves to answer. About 39 percent of women will die within a year following a major heart attack compared to only 31 percent of men.
Women experience more congestive heart failure than men.
Women don't do as well following angioplasty and bypass surgery as men, perhaps because they are generally older when it occurs or possibly because they have smaller arteries than men. To complicate matters further, diagnostic testing is often less accurate and results in more false positives than in men. High triglycerides, obesity and a sedentary lifestyle are secondary risks. To prevent heart disease, many physicians now prescribe estrogen replacement therapy, but it also carries the risk of increased uterine cancer and breast cancer. Frankly, we are not sure about the long term effects of estrogen replacement therapy on heart disease.