Heart Disease in Women: Understanding Cardiovascular Risk Factors

Cardiovascular disease impacts women as much as it impacts men. Heart disease is the leading cause of death in both women and men.

However, women are vulnerable to heart problems beyond the traditional risk factors that increase the likelihood of heart disease. To keep ahead of heart disease, women under age 65 should start paying attention to their heart, any risk factors they have, particularly if they have a family history of disease.

All of my patients deserve to know as much as possible about heart disease. Women have more complex causes of heart problems, and I am committed to educating female patients on what can lead to heart disease in women and how we can work together to prevent it.

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Heart Disease Symptoms in Women

Heart attack symptoms can be different for women. While chest pain, pressure or discomfort are the most common symptoms for both, it often presents differently in women.

Women should pay attention to:

• Chest Pain: Can vary by person, with some being chest discomfort that comes and goes, while other women might experience pressure or tightness. Some women can have a heart attack without chest pain at all.
• Neck, Jaw, Shoulder, Upper Back or Upper Belly Discomfort: Unusual discomfort in these areas can be a sign of a heart attack or other heart issues.
• Shortness of Breath: Even without chest pain, difficulty breathing can be an early sign of a heart attack.
• Pain in One or Both Arms: Unexpected arm pain could be a symptom of heart disease.
• Nausea or Vomiting: Feeling sick to your stomach or vomiting could be a sign of heart problems.
• Sweating: Sudden or unusual sweating without a clear reason could be a symptom of a larger issue.
• Lightheadedness or Dizziness: Feeling faint or dizzy can be a clue that your heart is in distress.
• Unusual Fatigue: Extreme tiredness that doesn’t have an obvious cause could be due due to a heart condition.
• Heartburn (Indigestion): Unexplained indigestion or heartburn can indicate that blow in not flowing through your heart properly.

Understanding Common Risk Factors in Heart Disease

Both men and women need to understand what conditions or habits can cause or lead to heart disease. By knowing  your risks of cardiovascular disease, you can reduce your chances of having heart disease. I always encourage patient to be active in making changes now to prevent heart problems early.

You should reach out to your doctor if you have one or more of those common risk factors:

• Quitting smoking is the number one everyone can do to prevent heart disease. Smoking, including e-cigarettes, is the most preventable cause of death in the United States. Giving up the habit can have a huge effect on your health, life span and ability to enjoy life down the road.
• If you have high cholesterol, monitor it and/or take cholesterol lowering medications, like statins. This can help manage your cholesterol and prevent fatty deposits from building up in arteries (atherosclerosis), decreasing coronary artery disease, heart attacks and more. 
• For those with hypertension (high blood pressure), working with your doctor to control your blood pressure through diet, exercise and/or medication will improve your overall heart health.
• Because diabetes can damage many organs in the body, including the heart, maintaining a healthy blood sugar will be a serious benefit to your heart function.

5 Causes of Heart Disease in Women

The best defense against heart disease is ensuring that women understand both the traditional risk factors that affect men and women and the female-specific cardiovascular risk factors. This will empower them to recognize gender-specific risks and ask the right questions about their heart health.

1. History of Pregnancy Complications

A history of pregnancy-related complications and/or poor pregnancy outcomes can raise a woman’s lifetime cardiovascular risk. Common conditions include:

• Preeclampsia (high blood pressure in pregnancy, sometimes with fluid retention and proteinuria),
• Pregnancy related hypertension (high blood pressure)
• Gestational diabetes (diabetes that develops in women during pregnancy)

Having one or more of those conditions increases the likelihood of developing heart disease in your life. Current guidelines recommend these women be referred for cardiovascular risk reduction guidance within the first 3 months postpartum to be proactive before a serious problem arises.

2. Premature Menopause, Menopause and Perimenopause

During and after menopause, a woman's body gradually decreases their estrogen production. Because estrogen is associated with lower blood pressure and cholesterol levels, women in premature menopause (before age 40), menopause and perimenopause are more susceptible to cardiovascular disease, including stroke.

Preventing heart disease before and after menopause can start with small changes that can have big impacts, such as:

• Regular exercise
• Annual wellness check-ups to monitor your blood pressure, cholesterol and blood glucose
• Maintain a heart-healthy diet

3. Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome is a metabolic syndrome that can cause excess body fat, hypertension, abnormal cholesterol levels, diabetes and more. Having one or more of these conditions associated with PCOS can more than double a women’s lifetime risk of a heart attack or stroke.

If you are diagnosed with PCOS, it is important to meet with a preventive cardiologist to lower your risk of heart disease. This might include monitoring your blood pressure, cholesterol and blood sugar to identify any early heart issues.

4. Autoimmune Diseases

Systemic autoimmune disorders, like lupus or rheumatoid arthritis, are highly prevalent in women and increase the risk of coronary heart disease and stroke.

Women with an autoimmune disease should be evaluated early for cardiovascular disease. Where needed, high-risk women can be treated with a heart-healthy diet, exercise and/or a long-term management plan for high blood pressure or cholesterol. It is never too early to intervene to reduce heart disease risk.

5. Psychological and Social Factors

For women, risk factors are not limited to physical conditions. Psychological and social factors can also lead to cardiovascular disease in women. If you are experiencing depression, stress, anxiety, post-traumatic stress disorder (PTSD) or abuse, you have an increased risk of developing heart disease.

These psychological and/or social factors can lead to on-going high blood pressure, which forces the heart to work harder. These physical reactions can make an existing heart condition worse or cause a new heart problem, such as a heart attack.