Heart disease and women: an overview
In the past, physicians’ understanding of heart disease was based on how it affects white men. Unfortunately for women’s heart health, that meant that the unique symptoms they were experiencing were easily overlooked.
These days, researchers and providers know that women’s heart health deserves specialized care, especially since heart disease is the leading cause of death for women in the U.S., resulting in one out of every three deaths per year. Nearly half of all women in the U.S. are living with some form of heart disease, which is why it’s imperative for women to know as much as they can about heart disease — and to advocate for themselves at every age and stage.
Heart disease symptoms in women
Unlike men, who may experience a sudden episode of chest pain, women with heart disease tend to report more subtle symptoms such as shortness of breath, arm or shoulder discomfort, jaw pain, dizziness, nausea, back pain or unexplained fatigue. To make things more complicated, these symptoms can present in the absence of chest pain. That’s why, if a woman has risk factors for heart disease and is experiencing any of these symptoms, she should seek medical attention for further evaluation.
Women's hearts need special care
Heart disease risk factors in women
There are many risk factors for heart disease. The good news, though, is that many of them can be modified with lifestyle changes and/or medications. Risk factors include:
- High blood pressure
- High cholesterol
- Diabetes
- Smoking
- Obesity
- Eating an unhealthy diet
- Drinking too much alcohol
- Living a sedentary lifestyle
- Stress
Unfortunately, you cannot change your genetics, so it’s important to know if you have a family history of heart disease.
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How pregnancy and menopause can affect heart health
Women’s heart health can also be impacted by their reproductive health and pregnancy. These risk factors include hypertensive disorders of pregnancy (for example, gestational hypertension or preeclampsia/eclampsia), gestational diabetes, delivery of a low birth weight baby, preterm delivery (less than 37 weeks), polycycstic ovarian syndrome and early age of first period.
On the other end of the spectrum, menopause is known to raise a woman’s risk of developing heart disease, while the hormonal changes associated with it may complicate her ability to recognize symptoms.
Heart-healthy diet and lifestyle modifications
Vanderbilt cardiologist Dr. Jessica Duran offers these recommendations for modifying your lifestyle to support the health of your heart: “Focus on eating a diet that is rich in fruits, vegetables, whole grains, legumes, poultry, fish and nuts,” she tells her patients. “Limit your intake of red and processed meats, saturated and trans fats, and full-fat dairy products. Also, minimize your intake of sugar-sweetened foods and beverages. You should also quit smoking, lose weight if needed and make physical activity a part of your daily routine. Based on your cholesterol level and personal risk, your health care provider may also recommend cholesterol-lowering medications to help you achieve a healthy cholesterol level.”
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The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic activity (like brisk walking, biking or dancing) or 75 minutes of vigorous aerobic activity (running, cycling or hiking), or a combination of both, spread throughout the week. You should also incorporate muscle strengthening activities into your routine several times per week.
To improve your heart health and extend your life, it’s also important to decide to quit smoking, vaping or using any form of tobacco. Talk to your health care provider to learn more about available resources, therapies and medications to help you successfully quit.
Tips for lowering stress
Statistically, women are 28 percent more likely to be stressed than men — and chronic stress can take a toll on heart health, as well as mental health. Stress management and self-care are crucial components to a heart-healthy lifestyle. Michelle Foote-Pearce, a psychotherapist with the Osher Center for Integrative Health offers these tips and more for managing stress.
- “Be realistic about all the things that need to be done and what we can get done now,” she recommends. “Do one thing at a time and engage with it. Maybe do our to-do list in the beginning of the day, then just check back periodically, but don’t think about everything that we have on our plates constantly. Be present and intentional.”
- “I usually ask people, ‘What’s the thing that you feel the most stressed about? What’s depleting you the most?’ Let’s start there. What’s the hardest thing for you? People usually know what that hardest thing is, and we start there with baby steps. Then we begin to shift that and can tackle the other things. We’re not going to do everything at once because that’s going to be more stressful.”
- “What self-care is not is trying to meet the ideal and that perfection,” she said. “It’s really about: What do I need to take care of myself at this stage of my life with this level of stress? There are so many ways we can take care of ourselves, but it’s about listening to yourself, identifying what you need and being intentional about it.”
Why women need specialized heart care
Since women are often the main caregivers in their homes and their symptoms can easily be attributed to other causes, their own heart health often gets overlooked. That’s why it’s important to understand your risk factors and be familiar with symptoms that may indicate heart disease — and to seek help when you need it.
Having a specialized multidisciplinary team focused on women’s heart health can offer an added level of expertise, comfort and support. Women need to feel empowered to ask questions about their health care and to be confident they’re being heard.
