Does physical activity offer greater benefits to some individuals than to others? A study, released on October 27 in Nature Cardiovascular Research, suggests that women might experience a superior advantage compared to men in terms of cardiovascular well-being.
Chinese researchers examined information from 85,000 individuals free of heart disease, all registered in the UK Biobank. This extensive dataset monitored participants’ physical activity via accelerometers and documented cardiac incidents and fatalities across a mean period of seven years.
Females adhering to exercise recommendations from the World Health Organization and the American Heart Association—specifically, 175 minutes weekly of moderate-to-vigorous exertion or 75 minutes weekly of intense physical activity—demonstrated a 22% reduced likelihood of experiencing cardiac events, in contrast to those who did not meet these recommendations. Males, in comparison, showed a 17% reduced risk.
Additional scrutiny revealed that women could decrease their cardiovascular risk with less physical activity than men. To achieve a 30% reduction in risk, men needed to exercise for 530 minutes per week, whereas women required only 250 minutes of weekly physical activity—approximately half the duration.
Jiajin Chen, the lead researcher from the Institute of Cardiovascular Diseases at Xiamen University Cardiovascular Hospital, expressed considerable surprise, stating, “We are quite surprised that females achieved cardiovascular benefits comparable to those of males with only about half” the physical activity. Furthermore, women who engaged in the recommended level of exercise “experienced a striking threefold reduction in mortality risk compared with males.”
Dr. Emily Lau, who directs women’s heart health at Brigham and Women’s Hospital and the Massachusetts General Heart and Vascular Institute, authored an accompanying editorial discussing the study’s conclusions and their significance. She noted, “Women appear to have a physical activity advantage.” However, she added, “Yet we see time and time again that women are less physically active and less likely to achieve the recommended physical activity targets. This highlights an opportunity for the medical community to think about how we can tailor our recommendations to women. Because what we are doing now is not quite working.”
These findings serve as a foundation for further research to more thoroughly investigate why women might gain greater advantages from exercise than men, even with reduced activity levels. Although the study itself did not delve into possible explanations, Chen indicated that scientists hold several theories. Primarily, women possess higher estrogen concentrations than men, and prior to menopause, estrogen might offer protective effects on cardiovascular health—partially accounting for why women typically experience cardiac events at older ages than men. Clinical trials further suggest that men supplementing with estrogen can improve their coronary heart disease, as it aids in lipid breakdown during physical activity. Additionally, distinctions exist in muscle composition and metabolism between men and women.
Chen’s analysis did not investigate whether menopause, which leads to a decrease in estrogen, resulted in any variations in the exercise benefits observed in women. Nevertheless, the women participating in the study were predominantly older, with an average age close to 62, suggesting most were likely post-menopausal. The limited number of pre-menopausal women made a dependable comparison unfeasible.
Drawing from these outcomes, Chen stated, “our findings provide valuable evidence for sex-specific prevention of coronary heart disease by using wearable devices.” He added, “We believe that in the era of personalized medicine, future interventions will increasingly be tailored to individual characteristics to maximize cardiovascular benefits.”
Lau concurred, asserting that “we have to stop treating men and women as the same.” She emphasized, “It’s 2025, and we are still doing the same things where we take data from men and extrapolate them to women. We see studies telling us men and women are different, yet the guidelines for them are all the same.”
This potential outcome could result in more precise guidance for enhancing heart health, advice that might differ for women and men—not solely concerning exercise, but also for other cardiovascular risk factors. Lau concluded, “It’s time for us to really change the framework for how we think about sex-specific research and clinical recommendations.”