Heart disease has been the leading cause of death for women in the U.S. for decades — it currently kills about one out of every four women.1,2 But, for many years, people thought that women didn't need to worry about heart disease, so research, education and awareness campaigns were mainly focused on men.
Because of this, doctors didn't fully understand how heart disease affected women, making diagnoses hard, and women didn't think to watch out for heart disease. “Traditionally, men have been more aware of heart disease," says Ajay Joshi, MD, a cardiologist in Folsom with Hill Physicians Medical Group. “More recently, however, there has been a push to improve awareness for women. But there is always room for improvement."
If you're a woman, you're probably wondering what you should be worried about when it comes to heart disease. The good news is that more research and information are coming out about how heart disease risk factors and symptoms affect women specifically.
“Traditional heart disease risk factors can affect you in different ways, depending on how old you are and if you are male or female," says Joshi. A few factors women need to keep in mind include:
- Diabetes: Diabetes can damage blood vessels, raise blood pressure and is linked to obesity, which all increase the risk of heart disease. Diabetic women have a higher risk for heart disease than diabetic men.2
- Cholesterol: There are four numbers to worry about with cholesterol: LDL, HDL, total cholesterol and triglycerides. “When it comes to cholesterol and heart disease, total cholesterol and HDL numbers are more predictable for men, while LDL numbers are more predictable for women," says Joshi. Specifically, women with high triglycerides and low HDL levels are more at risk.2
- Age/menopause: Estrogen can lower the risk of heart disease. But estrogen levels decrease after menopause, which is why women tend to be older when they get heart disease. On average, women get heart disease 10 years later than men.2
- Smoking: Smokers are four times as likely to get heart disease as non-smokers because smoking can cause blood clots, raise blood pressure and damage blood vessels. Women who smoke have a higher risk of developing heart disease than men who smoke.2
Keep in mind that there are many other factors that contribute to heart disease, like diet and family history. Talking to your doctor is the best way to figure out which risk factors apply to you and how you can manage that risk.
One of the main concerns with women and heart disease is recognizing symptoms. “Physicians need to be more alert because women can have atypical symptoms," says Joshi. “And women themselves need to be more aware of their symptoms because they tend to overlook them."
Heart attacks are a great example of atypical symptoms. A heart attack happens when blood flow to your heart is blocked. The “classic" heart attack symptom is chest pain. But some women are more likely to have other symptoms, including shortness of breath, nausea, fatigue, heartburn or pain in the neck, arm, throat, abdomen or back.2
Another example is angina. It's the name for chest discomfort that you can get when an artery in your heart becomes narrow enough to reduce blood flow to your heart. The most common symptom of angina is episodes of chest pain or discomfort. But women can experience pain elsewhere, such as the abdomen, or they can just experience breathlessness, nausea or vomiting.3 And if angina sounds similar to a heart attack, it's because it can be an early warning sign for the diseases that cause heart attacks.
There are also other symptoms women need to look out for, such as heart flutters or an irregular heartbeat. Heart flutters get more common as women get older (because of estrogen levels).2 And although these symptoms aren't as serious, they can be signs of a problem with the rhythm of your heartbeat.
The bottom line is to make sure you are paying attention to anything that feels o. or wrong and talking to your doctor. “You need to visit your doctor if you have chest discomfort of any kind, shortness of breath, a change in your level of fitness, or dizziness," says Joshi.
Even though thinking about heart disease risk factors, symptoms and consequences can be scary, it's important that both women and men stay aware. If you're looking for more on women and heart disease, or just heart disease in general, the American Heart Association and womenshealth.gov are great places to start.
More Resources on Heart Health
Heart Disease Health Center
2. womenshealth.gov/heart-disease-and-stroke/heart-disease 3. heart.org/en/health-topics/heart-attack/angina-chest-pain/ angina-in-women-can-be-di¥erent-than-men