Wellness tip: Understanding women’s heart health

Heart disease is the leading cause of death for women in the United States. Awareness of the risks and symptoms cannot be overstated.

Heart disease impacts roughly 60 million women across the United States, indiscriminate of age, according to the Centers for Disease Control and Prevention (CDC). Despite being the leading cause of death for women, with one in every five female deaths attributed to heart disease in 2021, only half of American women are aware of this risk1.

Women have specific risk factors for heart health, disease and failure, many of which are caused by gender-specific hormone changes and anatomy. Therefore, more widespread public awareness about the signs, symptoms and risk of heart disease in women, as well as a more gender-equitable approach to understanding women’s heart health in the medical community, are both needed to address these staggering statistics.

Understanding signs and symptoms

According to the CDC, there are three common types of heart disease in women. The most common is coronary artery disease, which is the leading cause of death for women in the United States, and poses a greater risk to women after menopause. Arrhythmia is another common heart disease, and refers to a heart that beats irregularly, too quickly or too slowly. Lastly, heart failure is the third most-common serious health disease among women1.

While some women have no symptoms, there are several to look out for, including1:

  • A dull or heavy ache or discomfort in the chest (angina)
  • Neck, jaw or throat pain
  • Back or upper abdominal pain
  • Nausea and/or vomiting
  • Excessive tiredness

These symptoms shouldn’t be taken lightly, but in the case of no symptoms, women who are experiencing signs of a heart attack — including chest, upper back or neck pain, indigestion, heartburn, nausea or vomiting, extreme fatigue, dizziness, shortness of breath, heart palpitations (a fluttering feeling in the chest), swelling of the feet, ankles, legs or abdomen — should seek immediate medical attention1.

Risk factors unique to women

Women have long been underrepresented in medical research, including when it comes to understanding cardiovascular health and heart disease, according to the American Heart Association2. Several health circumstances unique to women can impact their heart health. These include starting menstruation or menopause early, the use of oral hormonal birth control, pregnancy complications and outcomes, and polycystic ovary syndrome1, as well as being “disproportionately affected by inflammatory and autoimmune disorders,” which has been known to impact heart health2.

According to the National Institute of Health’s (NIH) Natural Heart, Lung and Blood Institute, women have anatomically different hearts compared to men. Structurally, women have smaller hearts with thinner muscular walls, and smaller blood vessels than men, and are more likely to manifest coronary microvascular disease, which impacts smaller arteries of the heart and can make identifying the disease more difficult3.

There are several other risk factors unique to women’s heart health, including anemia, high blood pressure — which affects more than 56 million women in the United States1 — endometriosis, mental health problems, metabolic syndromes and obesity3. Additionally, women with diabetes and/or low levels of high-density lipoprotein (HDL) or “good” cholesterol, as well as women who smoke, are at a greater risk of developing coronary heart disease, even more so than men with the same predispositions, according to the NIH3.

Understanding these specific catalysts, as well as educating the general public on signs, symptoms, and the level of risk, are key to creating gender-equitable approaches to women’s heart health.

Sources:

[1] Centers for Disease Control and Prevention (CDC). “Women and Heart Disease.” Accessed Jan. 14, 2024, from https://www.cdc.gov/heartdisease/women.htm.

[2] American Heart Association (May 9, 2022). “Report calls out gaps in women’s heart disease research, care.” Accessed Jan. 14, 2024, from https://www.heart.org/en/news/2022/05/09/report-calls-out-gaps-in-womens-heart-disease-research-care.

[3] National Institute of Health (NIH). “Women and Heart Disease.” National Heart, Lung and Blood Institute. Accessed Jan. 14, 2024, from https://www.nhlbi.nih.gov/health/coronary-heart-disease/women.