It has only recently been recognized that there are significant gender effects on heart disease and that women face increasing risks as they age. A longitudinal study of 246 older myocardial infarction (MI) patients included a 1/3 sample of women. Findings indicate that over the first post-MI year, women had greater risk of death, cardiac distress and reinfarction. Cardiac symptoms of men declined while those of women increased. Several medical care and social disadvantages were found among the post-MI women, including less aggressive cardiac care. Furthermore, since morbidity and mortality were related to medical care and social disadvantages, the results support gender-age stratification theories.