It might surprise you to learn that women are more likely than men to die from a heart attack. And each year, heart disease kills more U.S. women than all cancers combined.1,2 New research shows that heart disease is affecting more young people than ever before – especially young women. Yet most of us still consider heart disease to be a man’s disease. Because February is American Heart Month, take a moment to learn the facts about heart disease and what you can do to maintain your heart’s health.

What is Heart Disease?

The term heart disease, or cardiovascular disease, refers to several types of heart conditions, including coronary heart disease (CHD), heart attack, congestive heart failure, and congenital heart disease. The most common type of heart disease in the United States is coronary artery disease (CAD), which affects the blood flow to the heart and causes CHD. Decreased blood flow to the heart can cause a heart attack.3

More Young People – Especially Women – Are Developing Heart Disease

Heart disease doesn’t happen just in older adults. High rates of obesity and high blood pressure among young and middle-aged adults is putting them at risk for heart disease earlier in life. A study of two decades of data reveals that hospitalizations due to heart attack have steadily increased among individuals ages 35-64 – especially among women.4 About one in 16 women older than 20 (6.2%) now has coronary heart disease.1,2 In addition, nearly half of all Americans have at least one of the top three risk factors for heart disease: high blood pressure, high cholesterol, and smoking.5

Common Causes of Heart Disease

Common conditions and behaviors that increase a person’s risk for heart disease include:

  1. High blood pressure. Nearly half of U.S. adults have high blood pressure, and many of them don’t have it under control. Uncontrolled high blood pressure is one of the biggest risks for heart disease.3-5
  2. High cholesterol. High cholesterol increases the risk for heart disease. Smoking, eating unhealthy foods, not getting enough physical activity, having diabetes, and being obese can contribute to unhealthy cholesterol levels.4-6
  3. Smoking. Smoking damages blood vessels and can lead to heart disease.4,5,7 
  1. Obesity. Being overweight puts stress on the heart. More than 1 in 3 Americans – and nearly 1 in 5 children and adolescents ages 2 to 19 – are obese. Obesity is particularly risky for heart health when a person carries extra fat around the waistline.4,8,9
  2. Diabetes. High blood sugar levels adversely affect the inner layer of arteries. Over time these arteries can develop plaques that accumulate and reduce blood flow to the heart. 

Heart Disease Risk Factors for Women

Although most of the risk factors for heart disease affect women and men equally, some risk factors play a bigger role in the development of heart disease in women.10

  1. Diabetes. A woman with diabetes is more likely to develop heart disease than a man with diabetes.10 Because diabetes can change the way you feel pain, this increases the risk of having a “silent” heart attack – one without symptoms.11
  2. Mental stress and depression. Stress and depression appear to affect a woman's heart more than a man's.12 Chronic stress increases inflammation in the body, and over time, long-term inflammation can lead to atherosclerosis – the build-up of cholesterol and other fatty substances in the arteries, reducing blood flow to the heart.13 Chronic inflammation can also cause depression, which makes it difficult to maintain a healthy lifestyle and follow recommended treatments.12 
  3. Smoking. Smoking is a greater heart disease risk factor in women than in men.10,12 A woman who has diabetes and also smokes has 6-8 times the risk of having a heart attack compared to women who don’t have diabetes and don’t smoke.14
  4. Inactivity. A lack of physical activity is a major risk factor for heart disease. Some research has shown that women, in general, are less active than men, increasing their risk for coronary artery disease.12
  5. Menopause. A low level of estrogen after menopause poses a significant risk of developing disease in the body’s smaller blood vessels.10,12 In addition, early menopause – younger than age 40 – increases a woman’s risk for heart disease.14
  6. Pregnancy complications. High blood pressure or diabetes during pregnancy can increase a woman’s long-term risk of developing these two conditions, both of which make a woman more likely to get heart disease.12
  7. Family history of early heart disease. Having a family history of early heart disease is a greater risk factor for developing heart disease in women than in men.10,12

Symptoms of Coronary Heart Disease

Sometimes heart disease can be “silent” and go undiagnosed until a person experiences signs or symptoms. If you have any of the following symptoms that you think could be related to your heart, seek emergency medical help immediately.

Coronary artery disease and heart attack:  Although both of these types of heart problems share similar warning signs, each requires different treatments. Chest pain (angina) or pressure is the most common sign in both men and women. However, the pain is not always severe, and particularly not so in women. Women often describe it as pressure or tightness. Plus, it's possible to have a heart attack or suffer from coronary artery disease without chest pain.3,12,15

Women are more likely than men to have symptoms unrelated to chest pain, and can include one or more of the following symptoms:11,15

  1. Neck, jaw, shoulder, upper back, or abdominal discomfort
  2. Shortness of breath
  3. Pain in one or both arms
  4. Nausea or vomiting
  5. Sweating
  6. Lightheadedness or dizziness
  7. Unusual fatigue
  8. Indigestion

 Women tend to have symptoms more often when resting or while asleep than men.10-12

Heart Attacks are More Fatal for Women Than Men

Because women don't always recognize the symptoms of a heart attack, they tend to show up in the emergency room after heart damage has occurred. A report from the American Heart Association found that 26 percent of women will die within a year of having a heart attack compared with 19 percent of men. Within five years of having a heart attack, almost 50 percent of women die, develop heart failure, or have a stroke compared to 36 percent of men.16

How to Build a Healthy Heart at any Age 

Although most heart disease can be prevented with healthy lifestyle choices, it remains the number one health threat in the world. According to the American Heart Association, 80 percent of cardiovascular diseases are preventable.17 It is never too late to adopt a heart-healthy lifestyle. Here are a few things you can start doing today.

  1. Quit smoking. If you don't smoke, then don't start. If you do smoke, then research ways to help you stop. And try to avoid exposure to second-hand smoke, which can also damage blood vessels.1,7
  2. Get Active. Being physically active helps keep your heart and blood vessels healthy. Do some sort of physical activity for 150 minutes each week.18 You don’t need to be an exercise junkie – all movement helps. Try breaking up exercise into 10-minute blocks for a total of 30 minutes daily. 
  3. Maintain a healthy weight. If you're overweight, then losing even a few pounds can lower blood pressure and reduce the risk of diabetes.8,9,12
  4. Eat a healthy diet. Eat whole grains, a variety of fruits and vegetables, fish, and lean meats. Fill at least half your plate with vegetables and fruits. Avoid saturated or trans fats, added sugars, and high amounts of salt.1,3
  5. Manage your stress. Stress can increase your risk of heart disease.1 It increases inflammation and the level of a hormone called cortisol that can increase the risk for atherosclerosis, high blood sugar, and high blood pressure. To offset the effects of stress, try meditation, yoga, or tai chi. Spending time in nature is often helpful. One study even concluded that living near green space can help women live longer and improve their mental health.19
  6. Limit alcohol. If you have more than one drink a day, then cut back. One drink is approximately 12 ounces (360 milliliters) of beer, five ounces (150 milliliters) of wine, or 1.5 ounces (45 milliliters) of distilled spirits such as vodka or whiskey.1

Want to help fight heart disease? Share this article with the women you love. It just might save someone’s life.

References

  1. Centers for Disease Control and Prevention. Women and heart disease. https://www.cdc.gov/heartdisease/women.htm. [Accessed Feb. 5, 2021.]
  2. American Heart Association Go Red for Women. Common myths about heart disease. https://www.goredforwomen.org/en/about-heart-disease-in-women/facts/common-myths-about-heart-disease. [Accessed Feb. 5, 2021.]
  3. Centers for Disease Control and Prevention. About heart disease. https://www.cdc.gov/heartdisease/about.htm. [Accessed Feb. 3, 2021.]
  4. Arora S, Stouffer G, Kucharaka-Newton A, et al. Twenty-year trends and sex differences in young adults hospitalized with acute myocardial infarction. Circulation 2019;139:1047-1056.
  5. Virani S, Alonso A, Benjamin E, et al. Heart disease and stroke statistic – 2020 update: A report from the American Heart Association. Circulation 2020;141(9):e139-e596. 
  6. Centers for Disease Control and Prevention. Cholesterol. https://www.cdc.gov/cholesterol/. [Accessed Feb. 5, 2021.] 
  7. Centers for Disease Control and Prevention. Smoking and tobacco use. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/index.htm?s_cid=osh-stu-home-spotlight-001 [Accessed Feb. 5, 2021.]
  8. Centers for Disease Control and Prevention. Childhood obesity facts. https://www.cdc.gov/obesity/data/childhood.html. [Accessed Feb. 5, 2021.] 
  9. Centers for Disease Control and Prevention. Adult obesity facts. https://www.cdc.gov/obesity/data/adult.html. [Accessed Feb. 5, 2021.] 
  10. Pagidipati N. Clinical features and diagnosis of coronary heart disease in women. https://www.uptodate.com/contents/search. [Accessed Feb. 5, 2021.]
  11. Office on Women's Health. Heart attack symptoms. https://www.womenshealth.gov/heart-disease-and-stroke/heart-disease/heart-attack-and-women/heart-attack-symptoms. [Accessed Feb. 5, 2021.]
  12. National Heart, Lung, and Blood Institute. Ischemic heart disease. https://www.nhlbi.nih.gov/health-topics/ischemic-heart-disease. [Accessed Feb. 5, 2021.]
  13. Liu Y, Wang Y, Jiang C. Inflammation: The common pathway of stress-related diseases. Front Hum Neurosci 2017;11:316. 
  14. Personal communication. Lopez-Jimenez F. Mayo Clinic. Feb. 15, 2021.
  15. American Heart Association Go Red for Women. Symptoms of a heart attack. https://www.goredforwomen.org/en/about-heart-disease-in-women/signs-and-symptoms-in-women/symptoms-of-a-heart-attack. [Accessed Feb. 5, 2021.]
  16. Mehta L, Beckie T, DeVon A, et al. Acute myocardial infarction in women: A scientific statement from the American Heart Association. Circulation 2016;133(9):916-947.
  17. American Heart Association Go Red for Women. About heart disease in women. https://www.goredforwomen.org/en/about-heart-disease-in-women. [Accessed Feb. 5, 2021.]
  18. U.S. Department of Health and Human Services. Physical activity guidelines for Americans. 2nd ed. https://health.gov/paguidelines/second-edition. [Accessed Feb. 5, 2021.]
  19. James P, Hart J, Banay R, Laden F. Exposure to greenness and mortality in a nationwide prospective cohort study of women. Environ Health Perspect 2016;124:1344-1352.