Heart Disease in Women – Small Steps Can Lead to Big Strides in Health and Well-being

Michael Clark

By Michael Clark, M.D. | February 13, 2018

Heart disease affects more than 8 million women annually and is the leading cause of death in women in the United States. Surprised? You are not alone – the American Heart Association reports that long-standing misconceptions about women and heart disease continue to exist, particularly in younger women and those in racial minorities.

Several factors are probably responsible for this gap between perception and the reality of heart disease in women:

“Heart disease is a man’s disease” – This skewed perspective even influenced the medical community’s approach to women and heart disease risk. Women were excluded or under-represented in many of the earlier large clinical trials. Also, many women receive their health care from obstetricians and gynecologists whose focus is more on reproductive health and breast cancer awareness.

“I don’t have chest pain” – Although women will often present with “typical” chest pain symptoms, they are just as likely to have “atypical” presentations – abdominal pain or nausea, shortness of breath, or unusual fatigue.

“I’ve got other things to worry about” – When surveyed, women often don’t realize that they might be at risk for heart disease. Responses to the American Heart Association survey suggest that they are “too busy” or “too stressed” or may have other family members with health problems who they are taking care of. Underlying depression may make motivation more difficult, or there may be financial concerns that limit access to healthcare.

So, if that is the perception, what is the reality for women and heart disease?

“Riskier” risk factors – most of us are aware of the “classic” risk factors for cardiac disease – family history, hypertension, cholesterol abnormalities, diabetes, and smoking. These risk factors are just as powerful in women as in men and require the same attention to lifestyle and medication-related intervention. Women may also be at risk for cardiac disease from some “non-traditional” risk factors such as stress, depression, and physical inactivity. Obesity contributes to increased risk as it often leads to risk factor “clustering” – high blood pressure, elevated cholesterol, and diabetes present at the same time.

“Riskier” disease impact – In women, “atypical” angina presentations may lead to delay in diagnosis or misdiagnosis. Heart attacks in women tend to be more complicated and survival in the hospital and after discharge is worse than in men. Sudden cardiac death remains more common in men, but is occurring in women in increasing numbers.

The good news is that there is increased awareness of heart disease risk by women (and the medical community). More importantly, women now have improved guidance for prevention and disease management developed by nationally-recognized groups such as the Mayo Clinic. These common sense recommendations include:

  • Quit or don’t start smoking
  • Exercise regularly
  • Maintain a healthy weight
  • Eat a healthy diet, avoiding saturated or trans fats and excess salt.

You can’t be there for others if your heart is damaged. Make a pledge to yourself to live healthy – for you and for the ones you love.

Note: This post has been updated in 2020 to reflect current statistics.

This post is for informational purposes only and should not be considered as specific advice. Depending on your individual circumstances, the strategies discussed in this presentation may not be appropriate for your situation. The information in this material is not intended as medical advice. Always consult your medical professionals for specific information regarding your individual situation.

1 Comment

  • Avatar Ellen O'Toole says:

    Please read and recommend, Dr. Caldwell Esselstyn’s book, How To Prevent and Reverse Heart Disease to those who wish to avoid heart disease.

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