You might be surprised to learn that more women than men have died from cardiovascular disease in the United States since 1984. In fact, cardiovascular disease (heart disease and stroke) is responsible for one in three female deaths each year. People tend to underestimate the degree to which heart disease affects women; heart disease in women is much more common than most people might guess.
Taking care of your heart means understanding your own risk. Heart disease in women comes with different risks and warning signs than heart disease in men.
Let’s untangle the misconceptions we have about women’s heart health.
Misperceptions About the Risk of Heart Disease in Women
The American Heart Association conducted a survey in 2003 that asked women a series of questions about their knowledge of heart disease and its risk factors. Researchers found that, while awareness has grown since the 1950s and ‘60s – when most women were only concerned for their husbands’ hearts – women today still don’t understand the magnitude of their own risk. Most women still believe they are at greater risk of developing breast cancer than heart disease, despite the staggering death statistics of heart disease in women we mentioned earlier.
One reason women are more concerned about breast cancer than heart disease is a difference of age at onset. Breast cancer tends to affect younger women, while the average female heart attack patient has her first event at age 70. It’s more typical for women in their 30s, 40s and 50s to know women who’ve had breast cancer than it is to know someone who has had heart disease. Breast cancer feels like a more immediate threat.
While cancer prevention is important, cardiovascular disease takes more lives annually than all types of cancer combined, so we must overcome our misconceptions and take this risk seriously. (4)
Heart Attack Symptoms for Women
If you’ve never witnessed a heart attack first hand, you may have an inaccurate representation in your mind. In television and movies, heart attacks are acted out with a hand pressed to the chest, the victim experiencing intense chest pain and dropping to his knees. We also see men grabbing an arm in pain, having trouble breathing, and struggling dramatically.
Those heart attack symptoms don’t always apply to women, which means that most of us are ill-informed on what to look for in a female heart attack.
Women’s heart attack symptoms are easily confused with anxiety or depression: shortness of breath, abdominal pain or tightness in the chest. Women are more likely to seek mental health treatment than men, so it makes sense that doctors would be more likely to attribute these symptoms to an anxiety attack rather than a heart attack. (5) Extreme fatigue, nausea, vomiting, dizziness and back or jaw pain are also typical for women with heart troubles. (6)
Women’s Silent Heart Attack
But that’s not all. Some studies show that more women than men suffer from what’s known as a silent heart attack, or a silent ischemia. Silent heart attacks can be so subtle that the victim might not even know she’s suffered a heart attack at all.
Symptoms can feel like the flu, indigestion, or even a pulled muscle in the abdomen. Despite the subtlety or lack of symptoms, a silent heart attack damages heart tissue in the same way as a regular heart attack. But it can leave the victim at a higher risk of further damage, because it often goes untreated and unmonitored. (7)
Risk Factors for Women
Many heart disease risk factors apply to both men and women: high blood pressure, high cholesterol, obesity, smoking, family history, age, poor diet and sedentary lifestyle. However, there are a few more risk factors to consider for heart disease in women.
Oral contraception, when combined with the existing risk factor of smoking, increases risk of heart disease in women by 20 percent. (6)
Menopause also increases risk due to the loss of estrogen. Endogenous estrogen in pre-menopausal women helps keep HDL cholesterol (the good kind) high and LDL cholesterol (the bad kind) low. As women go through hormonal changes later in life, the HDL to LDL ratio decreases, and risk of cardiovascular disease goes up. (5)
Diabetes and Metabolic Syndrome
Diabetes and metabolic syndrome are also risk factors for heart disease in women. This is true for both men and women, but they seem to impact women differently. Both diseases have been implicated in more fatal heart attacks in women. Metabolic syndrome also appears to cause early onset heart attacks in women, but not men. For women who’ve already had one heart attack, diabetes doubles their likelihood of having a second one or experiencing total heart failure. (5)
Preventing Heart Disease in Women
The first line of defense in the prevention of heart disease in women is healthy lifestyle changes.
Make the heart-healthy choice to engage in at least 30 minutes of physical activity at least five days a week. Adding light resistance training also improves insulin sensitivity, which can help prevent diabetes.
A great long-term goal is to replace fried and processed foods with fresh, heart-healthy fruits, vegetables, legumes and lean cuts of meat.
Look for foods that are not only rich in fiber, but also anthocyanins and carotenoids, two types of antioxidant that protect the heart and blood vessels. These foods include berries (blueberries, raspberries, strawberries), purple grapes and colorful veggies like beets, carrots, winter squash and tomatoes.
Green leafy veggies provide insoluble fiber to aid in digestion and flavonols, another protective antioxidant. (8)
Bone broth aids in healthy circulation and is also a heart healthy choice. It’s rich in minerals and electrolytes such as calcium, magnesium, potassium and phosphorus.
Stress reduction is also a key component in preventing heart disease in women. This can feel challenging for women who tend to take care of those around them before taking care of themselves. Developing strong friendships and participating in community programs can help reduce stress, in addition to learning to ask for help when we need it.
Regular Check Ups
Other valuable components of prevention are getting regular check ups, being aware of your blood pressure and cholesterol levels, and maintaining a healthy weight.
It’s also important to understand the difference in signs and symptoms of heart disease in women and men in advance of a cardiac event. Take charge of your health early and notify your doctors when something doesn’t feel right.