What Women Need to Know About Cardiovascular Risk

Jan 6, 2023


For many years, people thought heart disease and heart attacks were men’s problems. Research studies focused on men. Diagnoses and treatments were designed for men.

Today, health professionals recognize that heart disease is the top killer of women, responsible for more deaths than all cancers combined.

Yet just 44% of women say they know that cardiovascular disease is the top threat to their health, according to research in the American Heart Association journal Circulation.

“Many women don’t realize that they’re just as much at risk of heart disease and heart attacks as men are,” says Monica Divakaruni, MD, an Adventist Health interventional cardiologist with special expertise in women’s heart health. “It’s important that they understand their risks and know what symptoms to look for that might point to heart trouble.”

Gender differences in cardiovascular disease

Physically, a woman’s cardiovascular system is different from a man’s. Her heart is slightly smaller, she has smaller blood vessels and arteries, and her heart rate tends to be higher at rest.

“But it’s not a smaller cardiovascular system that puts women at risk,” says Dr. Divakaruni. “The risk factors for women compound with age. They tend to have higher cholesterol and blood pressure, plus weight gain as they near menopause.”

Those changes, influenced in part by drops in the body’s estrogen production, make women more vulnerable to heart disease and heart attacks. So can pregnancy-related conditions, such as preeclampsia.

Two intertwined facts also account for women’s place in heart disease statistics. The likelihood of experiencing a heart attack or stroke increases with age. And women in the U.S. live longer: an average of 81 years, versus 76 for men.

Risk factors for heart disease

Smoking, physical inactivity and excess weight raise the risk of heart disease in both sexes. But certain risk factors put women at even greater odds of having a heart attack: smoking and taking birth control pills; hormone replacement therapy; metabolic syndrome, which includes a large waistline, low “good” cholesterol, and high blood pressure, blood sugar and triglyceride levels; diabetes or prediabetes; yo-yo dieting; and depression.

Symptoms of heart disease in women

For women, reducing the odds of heart disease starts with changing diet and exercise behaviors and recognizing their unique symptoms of a heart attack.

The classic signs of a heart attack— shortness of breath and pain or discomfort in the center of the chest, back or jaw — are hard to miss. But subtler warning signs are more common in women: pressure or pain in any part of the chest, indigestion and heartburn, nausea and vomiting, shortness of breath, unexplained fatigue, back or shoulder pain or tightness or squeezing in the upper back, and lightheadedness.

“Many women delay longer than men in getting treatment for signs of heart attack,” Dr. Divakaruni says. “They’re often concerned with taking care of their family before themselves. But when you have heart attack symptoms, call 911. Every minute matters.”

Women and high blood pressure

Up to age 65, men and women experience hypertension (high blood pressure) at similar rates. But after 65, more women than men develop high blood pressure, according to the American Heart Association.

Because hypertension increases a person’s risk of heart attack and stroke, it’s important for women to be screened at least annually. “High blood pressure causes the heart to work harder, and that can lead to damage in the heart and in blood vessels all over the body,” explains Dr. Divakaruni.

Anyone diagnosed with high blood pressure should take steps to lower it. And your Adventist Health healthcare provider can help. 

Reach out to your provider’s office to schedule an appointment or find a primary care provider near you using our easy Find-a-Doctor search.