Heart Disease in Women: Are you at Risk?

By Kola Dushaj  MD  FACP  FHM | Internal Medicine

Cardiovascular disease is the number one killer of women, causing one in four female deaths each year. That’s approximately one woman every minute!

While heart disease is the leading cause of death for both men and women in the United States, there are some key differences between genders.

Heart attack symptoms for women

While some women have no symptoms, others experience angina (dull, heavy to sharp chest pain or discomfort); pain in the neck/jaw/throat; or pain in the upper abdomen or back. These may occur during rest, physical activity, or be triggered by mental stress. Sometimes heart disease may be silent and undiagnosed until a woman experiences signs or symptoms of a heart attack, heart failure, arrhythmia (chest palpitations/fluttering), or stroke. Other symptoms unrelated to chest pain, are:

• Shortness of breath
• Pain in one or both arms
• Nausea or vomiting
• Sweating
• Lightheadedness or dizziness
• Unusual fatigue

Women’s symptoms may occur more often when women are resting, or even when they’re asleep. Mental stress also may trigger heart attack symptoms in women.

Heart disease risk factors for women

Although several traditional risk factors for coronary artery disease —high cholesterol, high blood pressure and obesity — affect women and men, other factors may play an influential role in the development of heart disease in women, such as:

• Women with diabetes are at greater risk of heart disease than are men with diabetes.
• Mental stress and depression.Women’s hearts are affected by stress and depression more than men’s.
• Smoking.In women, smoking is a greater risk factor for heart disease.
• A lack of physical activity is a major risk factor for heart disease, and some research has found women to be more inactive than men.
• Low levels of estrogen after menopause pose a significant risk factor for developing cardiovascular disease in the smaller blood vessels.
• Certain chemotherapy drugs and radiation therapy for cancer.Some chemotherapy drugs and radiation therapies, such as those used to treat breast cancer, may increase the risk of cardiovascular disease.
• Pregnancy complications.High blood pressure or diabetes during pregnancy can increase women’s long-term risk of high blood pressure and diabetes and increase the risk of development of heart disease.

A woman’s symptoms are often different from a man’s, and she’s much more likely than a man to die within a year of having a heart attack. Women also don’t seem to fare as well as men do after taking clot-busting drugs or undergoing certain heart-related medical procedures. Research is only now beginning to uncover the biological, medical, and social bases of these and other differences. We are hopeful that new knowledge will lead to advances in tailoring prevention and treatment for women.