Exercise May Benefit Women’s Hearts More Than Men’s

Do some people benefit more from exercise than others? A study published October 27 in Natural Cardiovascular Research finds that women may have an advantage over men when it comes to heart health.

Researchers in China analyzed data from 85,000 people without cardiovascular disease enrolled in the UK Biobank, a dataset that tracked participants' physical activity levels using accelerometers and recorded cardiac events and deaths over an average of seven years.

Women who met the World Health Organization and American Heart Association recommendations (175 minutes per week of moderate-to-vigorous activity or 75 minutes per week of vigorous activity) had a 22% lower risk of heart disease compared to those who did not meet the recommendations, while men had a 17% lower risk.

Further analysis showed that women were able to reduce their risk of heart attack with less exercise than men. To reduce the risk by 30%, men had to exercise 530 minutes per week, while women only needed to be physically active 250 minutes per week: about half as much.

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“We are very surprised that women achieved cardiovascular benefits comparable to those of men by engaging in only about half the physical activity,” said Jiajin Chen, a researcher at the Institute of Cardiovascular Diseases at Xiamen University Heart and Vascular Hospital, who led the study. What's more, women who completed the recommended amount of exercise “experienced a striking three-fold reduction in mortality risk compared with men.”

Dr. Emily Lau, director of women's heart health at Brigham and Women's Hospital and Massachusetts General Heart and Vascular Institute, wrote comment about the findings and their consequences. “Women seem to have an advantage in physical activity,” she says. “However, we see time and time again that women are less physically active and less likely to achieve recommended physical activity targets. This gives the medical community an opportunity to think about how we can tailor our recommendations for women. Because what we're doing now isn't quite working.”

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The results are a starting point for more research to better understand why women may benefit more from exercise than men, even in smaller amounts. While the study didn't look at potential explanations for the findings, Chen says scientists have some theories. First, women have higher estrogen levels than men, and earlier menopauseEstrogen may protect cardiovascular health, which may partly explain why women tend to develop heart attacks later in life than men. Research also shows that men who take estrogen supplements may improve coronary heart disease because it helps break down lipids during exercise. There are also differences in muscle structure between men and women and in muscle metabolism.

Chen did not analyze whether menopause occurred after which Women's estrogen levels decreaseled to any differences in the training benefits women achieved. However, the women in the study tended to be older (likely already past menopause) with an average age of about 62 years. The number of premenopausal women was too small to provide a reliable comparison.

Based on the results, “our results provide valuable evidence to support sex-specific prevention of coronary heart disease using wearable devices,” says Chen. “We believe that in the era of personalized medicine, future interventions will increasingly be tailored to the individual to maximize cardiovascular benefits.”

Lau agrees, saying that “we have to stop treating men and women the same,” Lau says. “It's 2025 and we're still doing the same thing: taking data from men and extrapolating it to women. We see studies that tell us that men and women are different, but the recommendations for them are the same.”