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Women and Heart Disease

Heart disease is the No. 1 killer of women each year.

At least one in three women is living with some form of cardiovascular disease.

Cardiovascular disease is responsible for 35% of deaths in women each year – more than all cancers combined. It can affect women of any age, yet CVD in women is seriously understudied, under-recognised, under-diagnosed and under-treated. This is primarily the result of various misconceptions, including the widespread view that cardiovascular disease affects men more than it does women. Many people are actually unaware that women are just as vulnerable to heart disease as men.

Women and men share largely the same risk factors for heart disease. Smoking, being overweight or obese, high blood pressure and diabetes, as well as a family history of heart problems all contribute to an increased risk of heart attack. However, coronary heart disease can be different for women and women are more vulnerable to certain risk factors than men, for example, diabetes or smoking are even bigger dangers to women than men—especially to young women. 

Heart disease can affect women differently than men because:

  • Hormonal changes affect a woman’s risk for coronary heart disease. Estrogen raises levels of HDL cholesterol (sometimes called “good” cholesterol) and helps keep the arteries flexible so they can widen to deliver more oxygen to the tissues of the heart in response to chemical and electrical signals. Usually, before menopause, the hormone estrogen provides women with some protection against coronary artery disease. 

  • The size and structure of the heart is different for women and men. A woman’s heart and blood vessels are smaller, and the muscular walls of women’s hearts are thinner.

  • Women are more likely to have nonobstructive coronary heart disease or coronary microvascular disease.  These types are harder to diagnose than obstructive coronary artery disease, this can cause delays in getting diagnosed and treated.

Women of all ages should take heart disease seriously and pay close attention to CVD risk factors. It’s important to be aware of the risk factors that specifically affect women, and what you can do to look after your heart health.

Women's Unique Risk Factors

In addition to traditional cardiovascular disease risk factors, the risk of a heart attack or stroke may also be affected by women-specific risk factors.

Menopause

There may be higher risk for heart disease after the onset of menopause. Menopause causes changes to hormones, fat distribution and metabolism. As a result, women are at greater risk of high blood pressure, high blood sugar, excess body fat around their middle and abnormal cholesterol levels, all of which can increase their risk of heart disease.  

Women who start menopause at age 45 or younger (early onset menopause) have a higher risk of cardiovascular disease.

Birth control pills
(oral contraceptives)

For young women, oral contraceptives are usually safe. However, it does slightly increase your risk for heart disease, heart attack, blood clots and stroke. Women over 35 years of age or who smoke and use oral contraceptives, face a particularly higher risk of heart attack, stroke and blood clots. 

Pregnancy
Complications

Most women will have a perfectly normal pregnancy, but some will have some sort of complications of pregnancy that can increase their future risk of cardiovascular disease, including:

  • Gestational Hypertension (gestational hypertension can progress to preeclampsia)

  • Pre-eclampsia (high blood pressure condition that can affect all organs in a woman’s body)

  • Gestational Diabetes

Certain Health Issues

Some health issues such as polycystic ovary disease and autoimmune diseases such as rheumatoid arthritis or lupus can increase risk for heart disease. If you are affected by one of these, make sure to talk with your doctor about steps you can take to minimise your risk.

In addition to having unique risk factors for heart disease, some heart disease symptoms in women can differ from those in men, women may not know what to look for.

Preventing heart disease

Living a healthy lifestyle can help reduce the risk of heart disease. Try these heart-healthy strategies:

  • Know your numbers. Get your blood pressure, blood sugar and cholesterol checked regularly. If they are high, work with your doctor to lower them. This may include medication and lifestyle changes.

  • Quit smoking. If you don't smoke, don't start. Try to avoid exposure to secondhand smoke, which also can damage blood vessels.

  • Eat a healthy diet. Opt for whole grains, fruits and vegetables, low-fat or fat-free dairy products, and lean meats. Avoid saturated or trans fats, added sugars, and high amounts of salt.

  • Exercise and maintain a healthy weight. If you're overweight, losing even a few pounds can lower heart disease risks. Ask your health care provider what weight is best for you.

  • Reduce stress and treat depression. Your risk for heart disease increases if you're depressed or feel chronically stressed. Stress-reducing strategies include exercise, adequate sleep, relaxation techniques, and meditation. 

  • Avoid or limit alcohol. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.

  • Follow your treatment plan. Take medications as prescribed, such as blood pressure medications, blood thinners and aspirin.

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