Women’s heart health risk: 1 in 3 deaths each year

April 27, 2023

Cardiovascular diseases, including heart attack and stroke, cause 1 in 3 deaths in women each year¹. Some symptoms that women commonly experience during a heart attack are more subtle than the “classic” male symptoms. As a result, many women may not realize they are having a cardiovascular emergency and fail to seek treatment².

Here, we discuss valuable information about heart attack and strokes in women, including new tools that are available for managing your heart health, along with symptoms, prevention, and risk management.

The latest tools for managing your heart health

Technological advances have brought a variety of gadgets, such as smart-watches and other wearable devices, that can monitor physical activity as well as biometric outputs like heart rate and hearth rhythms. These data can be useful for monitoring risks, and in some cases can help alert you that something is wrong and to seek medical care³.

More traditionally, lifestyle modifications to manage risk factors like monitoring diet, cholesterol, and blood pressure can play a key role in managing your heart health. Recent studies have also shown that stress and depression are factors that can contribute to heart disease in women⁴. Finding ways to manage stress and depression, including finding time for relaxation, getting support from mental health practitioners or support groups, learning techniques to cope with stress, and getting treatment for depression can be valuable ways to reduce risk⁵. Finally, the United States Preventative Task Force has updated its recommendations for using low-dose aspirin as a preventative for heart disease, no longer recommending routine use for those at average risk and without existing heart disease and recommending against initiating low dose aspirin in patients over 60 years old to manage cardiovascular risk⁶. Talk to your doctor for further guidance on taking low-dose aspirin for heart health.

Heart attack symptoms common in men and women

Uncomfortable pressure, squeezing, fullness, or pain in the center of your chest; it can last more than a few minutes or go away and come back
Pain or discomfort in one or both arms, the back, neck, jaw, or stomach
Shortness of breath with or without chest pain
Breaking out in a cold sweat

Additional symptoms common in women

Unusual tiredness
Jaw, neck or upper back pain
Nausea or vomiting
Sudden dizziness or lightheadedness

Stroke symptoms in women and men

Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body
Sudden confusion, trouble speaking or understanding
Trouble seeing or blurred vision in one or both eyes
Sudden trouble walking, dizziness, loss of balance, or coordination
Sudden severe headache with no known cause

Prevention and knowing your risk

Risk factors for heart disease include those that we have some control of and others that are out of our control^7,8. To reduce your overall risk, it is important to understand your level of risk based on the factors you cannot change, and work on managing those factors that you can control.

Risk factors that can’t be changed

Age
Risk of heart disease increases with older age

Ethnicity
Statistics suggest that people of South Asian, African, and Caribbean descent have a greater risk for developing cardiovascular disease⁹

Genetics/family history
A family history including a first-degree relative with heart disease at a relatively young age (<55 years old for men, <65 years old for women)

Women with a family history may wish to consider genetic testing for themselves and their family members, to identify mutations in genes that are known to contribute to increased risk, including familial high cholesterol. In addition, they should consult their doctor to explore treatment options that may help to manage their risk factors.

Menopause
While menopause does not directly increase risk of heart disease, a woman’s risk tends to increase around the age of menopause. This can be affected by a decline in estrogen levels, a decrease in “good” cholesterol levels (HDL) in the blood, and other changes in a woman’s body that occur around this time.

Risk factors that can be changed

Blood pressure, cholesterol, and blood sugar levels are all biological factors that can increase the risk of heart disease. You can decrease your risk by getting annual screenings for these factors, knowing your results, and discussing strategies for managing these risks with your physician, including lifestyle modifications or treatment when necessary^7,8.

Lifestyle/behavior modifications

Stop smoking
Quitting smoking reduces cardiovascular risk

Eat a heart-healthy diet; the Mediterranean diet has been shown to decrease heart disease risk in women¹⁰
Incorporate fresh fruits and vegetables, whole grains, and lean meats

Avoid highly processed foods and trans fats

Limit sodium and added sugars

Be physically active
Aim for a minimum of 30 minutes of moderate exercise on most days

Maintain a healthy weight
A body mass index (BMI) of 18.5—24.9 is considered a healthy range

Limit alcohol
Moderate alcohol intake for women is defined as 1 drink per day

Biological factors

Manage blood pressure
Systolic blood pressure readings (the top blood pressure number) of 140 mm Hg or more and diastolic pressure (the bottom blood pressure number) of 90 mm Hg or more are considered high

Control cholesterol
Talk with your doctor about your cholesterol results, which will include your “good” cholesterol (HDL), “bad” cholesterol (LDL), total cholesterol, and triglycerides

Your doctor may recommend treatment for elevated cholesterol numbers

Reduce blood sugar
Talk with your doctor about the results of your blood sugar analysis

If your blood sugar tests indicate prediabetes or diabetes, you may need treatment to lower your blood sugar levels

References

Facts. www.goredforwomen.org https://www.goredforwomen.org/en/about-heart-disease-in-women/facts.
Cushman, M. et al. Ten-Year Differences in Women’s Awareness Related to Coronary Heart Disease: Results of the 2019 American Heart Association National Survey: A Special Report From the American Heart Association. Circulation 143, e239–e248 (2021).
Smart wearable devices in cardiovascular care: where we are and how to move forward | Nature Reviews Cardiology. https://www.nature.com/articles/s41569-021-00522-7.
Bucciarelli, V. et al. Depression and cardiovascular disease: The deep blue sea of women’s heart. Trends in Cardiovascular Medicine 30, 170–176 (2020).
Steptoe, A. & Kivimäki, M. Stress and cardiovascular disease. Nat Rev Cardiol 9, 360–370 (2012).
US Preventive Services Task Force et al. Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement. JAMA 327, 1577 (2022).
Life’s Simple 7 – American Heart Association – Workplace Health Playbook. https://playbook.heart.org/lifes-simple-7/.
Benjamin, E. J. et al. Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association. Circulation 139, e56–e528 (2019).
CDC. Women and Heart Disease. Centers for Disease Control and Prevention https://www.cdc.gov/heartdisease/women.htm (2022).
Pant, A. et al. Primary prevention of cardiovascular disease in women with a Mediterranean diet: systematic review and meta-analysis. Heart (2023) doi:10.1136/heartjnl-2022-321930.

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