A Comparative Study on Gender-Based Differences in Risk Factors, Clinical Manifestations, and Outcomes of Ischemic Heart Disease

Background: Ischemic heart disease (IHD) is the leading cause of global morbidity and mortality, with growing recognition of significant gender-based differences in risk profiles, clinical presentation, treatment patterns, and outcomes. Historically, cardiovascular research has predominantly focused on male populations, potentially contributing to under-recognition and suboptimal management of IHD in females. Objective: This study aimed to comparatively evaluate gender-based differences in risk factors, clinical manifestations, diagnostic findings, management strategies, and short- and intermediate-term outcomes among patients with IHD. Methods: A retrospective comparative analytical framework was applied to a representative dataset of 1,000 patients diagnosed with acute coronary syndrome or chronic IHD (600 males, 400 females). Demographic characteristics, cardiovascular risk factors, presenting symptoms, electrocardiographic and angiographic findings, treatment modalities, and outcomes (in-hospital, 30-day, and 1-year) were analyzed. Categorical variables were compared using chi-square tests and continuous variables using independent t-tests. Multivariable logistic regression was performed to identify independent predictors of 30-day mortality. Results: Females were older at presentation and exhibited higher prevalence of hypertension and diabetes mellitus, whereas males had significantly higher smoking rates. Females more frequently presented with atypical symptoms such as dyspnea and fatigue, while males more commonly reported typical chest pain. Females experienced longer delays to reperfusion therapy and underwent invasive procedures less frequently. Although crude 30-day and 1-year mortality rates were slightly higher among females, multivariable analysis demonstrated that gender was not an independent predictor of mortality after adjusting for age, comorbidities, STEMI presentation, and reperfusion delay. Conclusion: Significant gender-based differences exist in the risk profile, symptom presentation, and management of IHD. Many observed outcome disparities appear mediated by age, comorbid conditions, and delays in treatment rather than gender alone. Enhanced awareness of atypical presentations and equitable application of evidence-based therapies are essential to reduce gender disparities in cardiovascular care.