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Heart disease: Are the sexes created equal?

Romantics tell us that two hearts can beat as one, but the truth is that male and female hearts march to the beat of different drummers. The male heart beats more slowly (72 beats a minute) than the female heart (80 beats a minute) and is larger (weighing in at an average 10 ounces vs. 8 ounces).

But the differences aren’t merely cosmetic. Women differ from men both in their susceptibility to heart disease and in how the disease progresses once it takes hold. Here’s a rundown of ways in which men and women are dissimilar in matters of the heart:

Cigarette smoking increases a woman’s risk of heart disease more so than a man’s. In one study, smoking increased the risk of having a heart attack 57% more in woman than in men.

More women than men suffer from angina. Angina pectoris is chest pain that occurs when clogged blood vessels starve the heart of oxygen, and can be a warning sign of increased risk of heart attack.

Heart disease is detected later in women. Despite the early warning that angina can give, women are more likely than men to be diagnosed with heart disease at a more advanced stage—when it’s more difficult to treat.

Exercise electrocardiography is less accurate for women. The widely used exercise stress test (used to detect blocked coronary arteries) produces a high number of false-positive results in women, which may lead to unnecessary angiograms. In many cases, doctors now opt for exercise echocardiography—a test that uses ultrasound images—to evaluate coronary artery disease in women.

Despite the differences between men’s and women’s hearts, the sexes have one thing in common: Both can protect their hearts by controlling risk factors such as an unfavorable cholesterol profile, high blood pressure, excess weight, smoking and lack of exercise.