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A recent study found that 55% of women have plaque in the coronary arteries, highlighting that even small amounts of plaque may be more dangerous than they appear, particularly for women whose health can be affected at lower levels of blockage.
The findings challenge the common belief that women are naturally more protected from cardiovascular disease than men due to having less arterial blockage on average. The study suggests this assumption may be misleading and calls for closer medical monitoring.
Published in *Circulation: Cardiovascular Imaging*, the study analyzed data from 4,200 adults and found that while women have significantly less arterial plaque than men, their risk of heart attacks and death is comparable. This suggests that the perceived protective advantage may not fully reflect actual clinical risk.
Smaller Arteries, Higher Impact
The study, which included researchers from Harvard Medical School, found that 55% of women had coronary artery plaque compared to 75% of men.
It also showed that plaque volume in women was roughly half that of men (78 mm³ versus 156 mm³). However, researchers noted that these figures do not fully reflect risk levels.
Women naturally have smaller arteries, meaning that even limited plaque buildup can significantly restrict blood flow and become clinically dangerous.
Dr. Borik Foldina noted that “a small amount of plaque can have a much greater effect.” According to the findings, cardiovascular risk in women begins to rise at around 20% artery blockage, compared to about 28% in men.
Medical Standards Under Question
The differences suggest that current global cardiovascular risk thresholds may not accurately reflect female physiology. Many risk models are based primarily on male populations, which can lead to underestimation of risk in women and delays in preventive care.
In 2026, cardiovascular disease caused more than 433,000 deaths among women in the United States, accounting for nearly half of all heart-related deaths.
Dr. Stacey E. Rosen of the American Heart Association emphasized the importance of recognizing biological differences, stating: “It is time to acknowledge fundamental biological differences.”
Toward More Accurate Risk Assessment
The study reflects a broader shift toward more personalized approaches in cardiovascular medicine. Symptoms, risk factors, and treatment responses can differ between men and women, making individualized assessment essential.
Experts stress that evaluating heart health should not focus only on the degree of arterial blockage, but also on artery size and biological context. This approach supports more accurate prevention strategies and better protection for women at risk of heart disease.
