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Women and Heart Disease: Know the Facts About This No. 1 Killer

When we see a heart attack victim in the movies, typically we see a middle-aged man gripping at his chest and falling to the floor in dramatic fashion. Unlike in movies, heart disease doesn’t just affect men, it affects women as well, and it isn’t always so apparent.

If you’re like many other women, you may worry more about breast cancer, or cancer in general, than you do heart disease. However, heart disease remains the No. 1 killer of women.

The good news? Although it is extremely prevalent, about 80% of cardiovascular disease, including coronary artery disease, stroke and heart attacks, are preventable.

So, take to heart, women, and learn how to protect it. Here are five important facts you should understand about your heart and your risk for cardiovascular disease.

1. Heart disease kills more women than all cancers combined.

Heart disease takes the life of more than 300,000 women each year – or causes about 1 in every 5 female deaths. In addition, 1 in 16 women age 20 and older (6.2%) have coronary heart disease. Yet many women worry less about heart disease than cancer, even though nearly twice as many women die from heart disease than all forms of cancer combined.

2. Heart disease symptoms in women can be really hard to recognize.

“Women tend to have a greater number of more subtle or atypical symptoms than men, regardless of the presence of chest pain,” said Ameera Ahmed, MD, an interventional cardiologist with Banner Health in Fort Collins, CO. “And health care providers may be less likely to attribute these symptoms to heart disease, in comparison to men. In addition, most large cardiology research trials are only made up of 25 to 30% women, on average, adding to the challenge.”

Most of us are conditioned to believe that a telltale sign of a heart attack is extreme chest pain. In reality, however, women may experience symptoms like fatigue, back and jaw pain, dizziness, passing out, shortness of breath, sweating, nausea, vomiting and difficulty sleeping.

Because heart disease symptoms can vary greatly between men and women, they’re often misunderstood. Many women are more likely to brush their symptoms off or assume the cause is related to something else, such as the flu and general fatigue.

“As more women are being included in research studies, we’re learning more about the gender differences in heart disease and how to better recognize and treat their conditions differently,” Dr. Ahmed said.

3. Women without a family history can still have heart problems.

A family history of cardiovascular disease can put you at greater risk, but so do many other known factors: high blood pressure, high cholesterol, elevated blood sugar, smoking, lack of exercise, poor diet and obesity. And 90% of all women have at least one of these risk factors.

In addition, certain conditions that only, or primarily, affect women also appear to influence your risk for heart disease, including gestational diabetes, preeclampsia and being postmenopausal. Prolonged stress and lack of self-care can also affect your heart health, says Dr. Ahmed.

“Mental health disorders like depression, anxiety and post-traumatic stress disorder (PTSD) are drivers behind certain diseases,” she said. “PTSD is associated with a 61% increased risk of coronary artery disease.”

[Learn more about Women’s Heart Risk Factors.]

4. Women with heart disease often aren’t accurately diagnosed and don’t receive the right care.

“Women are less likely to be diagnosed, treated and receive (or be offered) lifesaving care in a timely fashion,” Dr. Ahmed said. “In fact, even when seeing their health care provider, cardiovascular disease isn’t the top concern for women or their provider. Often more emphasis is put on weight issues and breast health.”

A general lack of awareness of women’s heart disease, atypical signs and symptoms and underlying sex and gender differences may all be contributing factors that result in less aggressive diagnosis and treatment in women.

Research has shown that women are less likely than men to receive aspirin, prescriptions for beta-blockers, statins and ACE inhibitors, as well as lifesaving procedures, such as heart catheterizations, later during a heart attack.

5. Heart attacks among young women are on the rise.

Heart disease doesn’t happen just to older adults. Risk factors like obesity and high blood pressure among young and middle-aged women is putting them at risk for heart disease earlier in life—especially those ages 35 to 64. Moreover, women ages 45 and younger are more likely to die within a year of their first heart attack.

“It’s never too early to care for your heart, but experts recommend screening starting at age 20,” Dr. Ahmed said.

These screenings include regular well women checkups with your health care provider and monitoring your blood pressure, cholesterol, weight and glucose levels. If you have a family history of heart disease, let your health care provider know early on as they may want to evaluate you.

“It’s important to note that not all heart attacks in women are from blockages or atherosclerosis,” Dr. Ahmed said. “There is also a category of heart attacks called MINOCA, or myocardial infarction with nonobstructive coronary arteries, which are not blockage related. These heart attacks can be caused by vasospasm (narrowing of the arteries), spontaneous coronary artery dissection (a tear in a blood vessel in your heart) and stress-induced cardiomyopathy.”

Take our heart age test to learn more about your heart risk.

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The more you know about heart disease, the better chance you have at preventing—and even beating it.

If you have questions or concerns about your potential risk for heart disease, don’t hesitate to talk to your health care provider.

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