Updated on March 15, 2024.
Anyone can be affected by heart disease. It is the number one cause of death in both women and men. But in the United States, 90 percent of women have at least one risk factor for heart disease and one woman dies of heart disease and stroke every eighty seconds. Some of those risk factors are unique to women, says Jennifer Yeh, MD, an interventional cardiologist at Memorial Health Physicians in Savannah, Georgia.
So, it’s very important for everyone to be aware of general risk factors for heart disease, such as being overweight, having a family history of heart disease, smoking, or having high blood pressure, high cholesterol, or diabetes. But women should be aware of the following four risk factors that affect them:
Menopause
For both men and women, the risk for heart disease increases with age. But heart attacks among women, in particular, increase about 10 years after menopause, according to the American Heart Association. This may be partly due to the fact that older women have lower levels of the hormone estrogen. Estrogen may have a protective effect on the walls of blood vessels by keeping them flexible.
With the hormonal changes of menopause come certain changes in metabolism, including weight gain. As a result, women are more likely to develop high blood pressure and diabetes. Their levels of LDL (aka “bad” cholesterol, a fat-like substance in the blood) and triglycerides (another type of fat in the blood) can also rise. Meanwhile, their levels of HDL (or “good” cholesterol) drop or stay unchanged. All of these things can increase heart disease risk, Dr. Yeh says.
Even younger women in their 30s or 40s need to be mindful about their heart health.
“More women are being diagnosed with heart disease in this younger age group due in large part to an increasing prevalence of obesity and sedentary lifestyles, as well as an associated rise in diabetes and continued tobacco use,” Yeh explains.
No matter how old you are, it is important to try and maintain a healthy weight and eat a heart-healthy diet that includes many different fruits and vegetables, whole grains, and healthy fats such as avocado, fatty fish like tuna, nuts and olive oil, Yeh says. The American Heart Association doesn’t recommend that women use hormone replacement therapy (HRT) as a way to reduce their risk of heart disease.
Polycystic ovary syndrome (PCOS)
PCOS is a hormonal disorder that develops when your body produces too much of the hormone testosterone and other hormones like it. This condition affects up to 12 percent of reproductive-aged women, according to the Centers for Disease Control and Prevention.
Possible side effects of PCOS include acne, extra facial hair, and weight gain. But the condition also increases the risk of heart disease. Those with PCOS are more likely to develop high blood pressure and to have unhealthy cholesterol levels. They’re also more likely to have type 2 diabetes. In fact, more than half of people with PCOS develop type 2 diabetes by age 40.
If you have PCOS, it’s important that your healthcare provider (HCP) check you for type 2 diabetes. It’s also important to try and maintain a healthy weight and stay as physically active as possible to help lower your risk of both diabetes and heart disease.
Health issues during pregnancy
If you’ve had gestational diabetes (diabetes that occurs during pregnancy) or pre-eclampsia (high blood pressure that occurs during pregnancy), make sure your HCP is aware. These conditions are linked to a higher risk for heart disease later in life. You should be closely monitored due to this increased risk, Yeh says.
If you’ve had high blood pressure during pregnancy, your risk of high blood pressure after your pregnancy may be up to four times higher. Your risk for heart disease and stroke may be twice as high, according to the Preeclampsia Foundation. Research also suggests that people with high blood pressure during pregnancy are at higher risk for high blood pressure and diabetes years later, reports the American College of Cardiology.
A 2017 study published in JAMA Internal Medicine also found that people who develop diabetes during pregnancy have a 43 percent increased risk of developing heart disease than those who do not have the condition. Keep in mind, the chances of this happening are still relatively low. The researchers also pointed out that the increase in risk was lower among those who did not develop type 2 diabetes and those who adopted heart-healthy lifestyle changes, including getting regular exercise, maintaining a healthy weight, following a healthy diet, and not smoking.
For some people, these issues earlier in life may help motivate them to make some heart-healthy changes.
Smoking
Smoking increases the risk for heart disease. And it may be even more dangerous for women than it is for men, says Yeh.
Women older than 35 who smoke have a slightly higher risk of dying from heart disease than male smokers in this same age group. It’s unclear why women are greater risk but, in general, smoking damages the blood vessels, which can increase the risk for atherosclerosis, or “hardening of the arteries."
Atherosclerosis occurs when deposits (or plaques) made of fat, cholesterol, and other substances build up in the arteries, causing them to become more narrow. This reduces the flow of blood to the heart, increasing the risk for heart attack, heart failure, problems with the heart’s electrical system, or even death.
Smoking can also lead to peripheral artery disease, which occurs when plaque builds up in the arteries that supply blood to other parts of the body, particularly the legs which can make walking painful or difficult. This condition also increases the risk for heart disease, heart attack, and stroke.
But once people who smoke stop smoking, their heart attack risk drops dramatically.
Managing your heart disease risk factors
It’s important to make sure that you’re up to date on all heart-healthy screening tests. This includes having your blood pressure checked at every healthcare visit. You should also have your cholesterol levels tested at least every four to six years and have your blood glucose level tested every three years after age 45. (Blood glucose is the amount of sugar in your blood.) If these numbers are already higher than normal or you have risk factors for heart disease, you should talk to your HCP about whether it makes sense to get screened more often.
You can help manage heart risk factors by taking the following steps:
Maintain a healthy weight (or lose weight if you are overweight or obese). Here are some steps that can help you lose extra pounds:
- Avoid sugary beverages, like soda.
- Be aware of your portion sizes at meal times or how much you eat at one sitting.
- Eat more slowly and chew your food well. This helps your brain recognize when you are full.
- Choose more foods with fiber, like fruits and vegetables. This can help you feel more full for longer.
- Sleep seven to nine hours each night. This can help you control your appetite and avoid cravings.
Follow a heart-healthy diet. In addition to eating different fruits and vegetables, add whole grains and lean protein, like chicken or fish, to your diet. Try to limit added sugar, salt, and saturated fats that are usually solid at room temperature, such as butter. These ingredients are often found in packaged foods, snacks, and desserts.
Do not smoke. If you do smoke, try to stop. For most people, it takes multiple tries to quit. Talk to an HCP about some strategies that can help you stop smoking for good.
Move your body more. Most adults should get at least 30 minutes of moderate-intensity physical activity most days of the week. But all movement counts and can be done in short bouts of activity, like a 10-minute walk or walking up the stairs instead of taking the elevator when you have a choice.
Depending on your individual needs and medical history, your HCP may also prescribe medication and recommend that you make lifestyle changes to protect your heart health.
It’s also important to be aware that women with heart disease may not develop the same warning sings as men, Yeh says. Instead, they may have shortness of breath, extreme fatigue, pain across the upper back and shoulders, or even bad indigestion, she explains.
If you have signs like these, call 911 and seek medical help right away. Be persistent and make sure any concerns you have about your heart health are addressed.
