Not Just a Man’s Disease: Understanding Heart Attacks in Women

Published on Feb 27, 2020

Heart disease has long been seen as a men’s health issue, but in fact, it’s the #1 killer of both men and women in the U.S. Some 300,000 women died from cardiovascular disease (CVD) in 2017, about one in every 5 female deaths.

For a variety of reasons, many women don’t view heart disease as a health threat. Surveys find that women worry more about breast cancer on a daily basis, even though heart disease claims the lives of six times as many women each year. Even more, younger women often don’t see heart disease as a personal health risk because it tends to show up later in life. But younger women are at risk, too. As CVD death rates have been declining overall, death rates in women ages 35-54 have been increasing.

The most common type of CVD is coronary heart disease, a common term for clogged arteries, which can lead to heart attacks. Many women who are at higher risk of CVD don’t recognize heart attack symptoms.

But the good news is that CVD is largely preventable. A recent study found that 75 percent of heart disease cases can be prevented with better lifestyle choices, such as quitting smoking, exercise and adopting healthy eating habits. Read on to learn more about heart disease in women and steps you can take to prevent the condition.

Not Just a Man’s Disease: Understanding Heart Attacks in Women

Risk factors

Some risk factors for heart disease, such as age, family history and certain conditions can’t be changed, but others are associated with your lifestyle choices and can be reduced.

Age: Starting at 55, women are at higher risk for developing heart disease. This is partly due to a drop in estrogen levels, a hormone that helps regulate blood cholesterol levels. Those who have gone through early menopause, either naturally or due to a hysterectomy, are twice as likely to get CVD than those who have not yet experienced menopause.

Family history: If your father or brother had a heart attack before 55 or if your mother or sister had one before 65, you are more likely to get heart disease.  

Pregnancy-related complications: Women who had complications such as gestational diabetes and preeclampsia (high blood pressure and signs of kidney or liver damage) during pregnancy, have an increased risk for heart attacks in the future.

High cholesterol: After menopause, women have higher concentrations of total cholesterol. Low HDL (good cholesterol) and high triglycerides (fat lipids in your blood) increase the risk of death from heart disease in women over 65.

Overweight or obese: Although obesity raises heart attack risk in both sexes, women with excess belly fat tend to have a higher heart attack risk than men with similar “apple-shaped” body types.

High blood pressure: Certain medicines, such as birth control pills, can make blood pressure rise. After age 55, women are more likely than men to develop high blood pressure.

Smoking: Women who smoke are more likely to have a heart attack than male smokers. And your chances of having a heart attack doubles if you smoke 1-4 cigarettes per day.

Diabetes or prediabetes: Diabetes increases the risk of heart disease in women more than men. On average, the first age of heart attack in men is 65, and 72 in women. But diabetes erases this age advantage. And in women who have already experienced a heart attack, diabetes doubles the risk for a second attack and increases the risk of heart failure.

Mental stress and depression: Research has found that women have a significant physical response to mental stress, which may increase their chances of heart attack. Women are also twice as likely than men to experience depression, which is a risk factor for heart disease.

Symptoms in women

While acute chest pain that lasts for more than a few minutes, or goes away and returns, is the most common heart attack sign in both sexes, many women don’t experience this classic symptom. Instead, they may have more subtle signs that can be mistaken for the flu, acid reflux or normal aging. Other than chest pain, women may experience the following heart attack symptoms:

  • Shortness of breath.
  • Pain or discomfort in one or both arms, back, jaw, neck or stomach.
  • Nausea or vomiting.
  • Lightheadedness.
  • Extreme fatigue or disturbed sleep in months leading up to attack.
  • Cold sweat, not to be confused with menopausal hot flashes.

If you think you or someone you know is having a heart attack, call 911 right away.

Gender differences

Women are more likely to die within a year of having a heart attack than men. Experts are still trying to better understand heart disease in women and why they tend to fare worse after heart attacks. One possible contributing factor is that women may not know their heart attack signs and delay seeking medical help. In addition, doctors may not recognize heart attack symptoms in women, mistaking them instead for panic disorder, stress, and even hypochondria.

Steps to reduce your risk

  • Talk with your healthcare provider to assess your personal risk.
  • Be more active. Just walking 30 minutes a day can lower your risk for heart attack or stroke.
  • Eat a healthy diet. Include vegetables, fruits, lean meats, fatty fish and nuts in your daily meals. And try to stay away from foods that are high in sodium and trans fats.
  • Take steps to quit smoking, if you smoke. One year after quitting, your risk of coronary heart disease may be reduced by 50 percent.
  • Reduce stress. Exercise, using relaxation techniques and meditating may help reduce stress.

By learning about the specific risk factors and symptoms associated with heart disease in women, you can take steps to help protect yourself.  When it comes to your body, you know it best.  Be sure to raise any concerns with your healthcare provider, and ask how you can reduce your risk factors and learn more about the condition.

References

  • 1. American College of Cardiology. “Women Don’t Get to Hospital Fast Enough During Heart Attacks.” March 5, 2015. Accessed January 27, 2020.
  • 2. American Heart Association. Fact Sheet. Cardiovascular Disease: Women’s No. 1 Health Threat. Accessed January 27, 2020
  • 3. American Heart Association. Go Red for Women. Symptoms of Heart Attack and Stroke in Women. Accessed February 20, 2020
  • 4. American Heart Association. Heart Attack Symptoms in Women. Accessed January 27, 2020
  • 5. Cardiosmart. American College of Cardiology. Gestational Diabetes Increases Women’s Risk for Heart Attack and Stroke. October 25, 2017. Accessed February 3, 2020.
  • 6. Centers for Disease Control and Prevention. Women and Heart Disease. Accessed February 3, 2020.
  • 7. Centers for Disease Control and Prevention. Women and Heart Disease Prevention. Accessed January 27, 2020.
  • 8. Harvard Health Publishing. Harvard Mental Health Letter. Depression and Heart Disease in Women. February 2012. Accessed January 27, 2020.
  • 9. Harvard Health Publishing. Harvard Heart Letter. Mental stress, gender and the heart. March 2018. Accessed January 27, 2020.
  • 10. Harvard Health Publishing. Gender matters: Heart disease risk in women. March 25, 2017. Accessed: January 27, 2020.
  • 11. Harvard Health Publishing. The Heart Attack Gender Gap. Accessed: February 19, 2020.
  • 12. Journal of the American Heart Association. Sex Differences in the Association Between Measures of General and Central Adiposity and the Risk of Myocardial Infarction: Results from the UK Biobank. February 28. 2018. Accessed January 27, 2020.
  • 13. Mayo Clinic. Heart Disease in Women: Understand symptoms and risk factors. Accessed January 27, 2020.
  • 14. National Heart, Lung and Blood Institute. High Blood Pressure. Accessed January 27, 2020.
  • 15. National Heart, Lung and Blood Institute. Listen to Your Heart: Learn about heart disease. Accessed January 27, 2020.
  • 16. Thielking, Megan. “Women who heart attacks fare much worse than men, study finds.” Stat News. January 25, 2016. Accessed January 27, 2020.
  • 17. University of Rochester Medical Center. Health Encyclopedia. Stress Can Increase Your Risk for Health Disease. Accessed January 27, 2020.
  • 18. WebMD. Heart Attack: Symptoms, Causes, Treatment and Prevention. Accessed January 27, 2020.
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