3 Facts Every Woman Should Know About Heart Disease.

Less than a century ago, heart disease was known as a “man’s disease.” As recently as the 1960s even the American Heart Association believed heart disease only affected men. Scientists thought estrogen protected women, at least until menopause. 

While there is a complex role that hormones play in heart disease, a clearer picture of women’s heart disease has come to light thanks to decades of research (which finally started to include more women in the 1980s). By 2000, studies showed that heart disease is a problem for both men and women, with women often facing different symptoms to men.

The Centers for Disease Control and Prevention now estimates more than 60 million women in the U.S. live with cardiovascular disease. Heart disease even outpaces cancer as the leading cause of death for women in the nation. 

The American Heart Association’s Go Red for Women campaign aims to raise awareness about heart health each February. Learning how heart disease affects women and the importance of preventative cardiology is something we can do all year. Signs of a heart in distress may be overlooked when life’s competing priorities combine with misunderstandings about heart disease and women.

Ninety percent of women have at least one risk factor for heart disease. Recognizing those risks early can go a long way in preventing heart disease later, and understanding signs of a heart problem can lead to better outcomes.

1. Women may experience heart disease symptoms differently than men.

There are universal symptoms of heart disease that both men and women can experience, such as chest pain, pressure, or heaviness, but a heart problem doesn’t always feel like crushing chest pain, especially for women. 

Women often experience more subtle warning signs of heart disease that can easily be missed, such as:

• Chest discomfort that feels like heartburn or indigestion

• Chronic fatigue, making it difficult to complete daily tasks

• Edema (swelling) in the lower legs or ankles

• Heart flutters or fast heartbeats

• Light-headedness or dizziness

• Nausea, loss of appetite, or vomiting with no dietary cause

• Shortness of breath

These symptoms shouldn’t be ignored, especially when you have other risk factors. If you experience these, talk with your doctor to rule out heart disease. 

2. Some heart disease risk factors are unique to women.

Levels of the hormone estrogen, which regulate the menstrual cycle and supports pregnancy, also helps protect the heart. The amount of estrogen in a woman’s body falls with age, especially during menopause. When those levels decline, the chance of developing heart disease can climb. 

Another uniquely female risk factor is having been pregnant, especially a high-risk pregnancy, which can have lasting effects on the heart. Mom’s heart not only needs to support her, but it also needs to nourish the growing baby. This requires the body to increase blood volume, cardiac output, and heart rate—all of which stress the cardiovascular system.

Heart health can become a concern for women when these types of risk factors are coupled with others, including:
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• Autoimmune diseases (such as lupus or rheumatoid arthritis)

• Depression and anxiety

• Diabetes

• Chemotherapy or radiation therapy, particularly breast cancer treatment

• Excess weight

• Family history of heart disease at an early age

• High blood pressure or high cholesterol

• High levels of stress

• Smoking

While some risks are beyond your control, many are manageable with lifestyle changes in partnership with medical providers. Taking small steps today can have a big impact on heart health tomorrow:

• Add a healthy exercise routine, usually 30-60 minutes of moderate-intensity activity five days a week

• Adopt a heart-healthy diet, like the Mediterranean Diet

• Manage blood pressure (normal is typically lower than 120/80 mmHg) 

• Monitor cholesterol levels, especially “bad” low-density lipoprotein or LDL (usually lower than 100 mg/dL)

• Quit smoking

Talk with your doctor about your specific risks so they can support you through lifestyle changes or add medications such as those to manage LDL cholesterol or high blood pressure if needed.

Related: Read "Menopause and Heart Health: Why Past Pregnancy Complications Matter."

3. You don’t need to wait for heart disease symptoms to visit a cardiologist.

Scheduling a consultation with a cardiologist is a great idea for women at risk of heart disease, even if there aren’t any noticeable symptoms. 

In addition to a physical exam, cardiologists use an array of tests to diagnose a possible heart condition, including:
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• Exercise stress tests to evaluate concerning symptoms

• EKG to check heart rhythm

• Heart ultrasound (echocardiogram) to examine the heart muscle and valves

• Coronary calcium scan to look for early signs of plaque in the heart arteries

Depending on results, more advanced imaging, testing, or procedures may be recommended by different cardiology specialists. These can include angioplasty to open a blocked artery, or a pacemaker to treat a rhythm disorder. 

Related: Read “5 Myths About Women’s Heart Health Debunked.”

Heart health is a collaborative partnership.

Prioritizing your heart health is the first step in protecting your heart. Recognize your risk factors and talk with your doctor about any heart-related concerns, big or small. 

If you need specialized services, cardiovascular care involves a multidisciplinary approach within our Women’s Heart Health Program. Working together, primary care doctors, a broad array of heart specialists, and cardiac surgeons provide collaborative care for all stages of your unique heart health.