If you’re a woman, your chance of developing—and dying from—heart disease is the same as a man’s. Yet research shows you may be less likely to get a prompt diagnosis or aggressive treatment. One reason may be the lack of knowledge about heart disease risk factors that only affect women. Here, Duke cardiologists explain what you need to know to keep your heart healthy.
The American Heart Association (AHA) recently published a landmark statement on how women’s experience of heart attacks—including the treatment they receive and how well they fare—is different from men’s.
If you’re a woman, one important difference surrounds your unique risks for heart disease. “The AHA statement confirms that risk factors like depression, marital stress and anxiety can put women at greater risk for heart attacks and heart disease than men,” said cardiologist Dr. Melissa Daubert, MD. Daubert directs a Duke program that focuses on identifying and reducing women’s heart disease risks as well as treating women with heart disease. These psychosocial risk factors are in addition to the traditional risk factors of high blood pressure, diabetes, high cholesterol, smoking history and a family history of heart disease.
Pregnancy complications affect heart disease risk
Some studies have shown that if you have a history of pregnancy complications such as gestational diabetes or pre-eclampsia, or if you had your first menstrual period by age 10, you may be at increased risk for heart disease. “There’s also some evidence that women with PMS are more likely to get high blood pressure, and women who have high blood pressure at a young age are more likely to develop heart disease,” said Pamela Douglas, MD, a Duke cardiologist and nationally recognized expert in heart disease in women.
Today’s women have more heart disease risk factors at a younger age
It's important to know what risk factors for heart disease you may have and how to control them to lower your risk. The most widely known risk factors are high blood pressure, high cholesterol, type 2 diabetes, smoking, obesity and lack of physical activity.
This is true even if you’re relatively young. “Younger women today tend to have more risk factors than younger women of previous generations did,” said Daubert. “So they should always be checked for high blood pressure, high cholesterol and diabetes, especially if they have a family history of heart disease or are overweight.”
Know the signs of a heart attack
Another important step is to make sure you—and your loved ones—are alert to the wide range of symptoms that can signal a heart attack. “How well a patient with a heart attack does, regardless of whether they’re a man or a woman, depends on how quickly they recognize the symptoms and get medical help,” said Duke cardiologist Dr. Tracy Wang, MD, MHS, MS, who was an author of the AHA statement.
A significant percentage of women with heart attacks have symptoms that aren’t thought of as typical. “Women may have chest pain that’s sharp or stabbing instead of a feeling of pressure,” said Daubert. “Women having heart attacks may have jaw, neck or arm pain. Or they may not have pain but instead have nausea, vomiting, sweating or a sense of impending doom. Those are just as important, but women sometimes don’t associate them with heart attack. Or they’re concerned that if they describe those symptoms, they may be seen as having anxiety.”
If you’re having these types of symptoms, seek medical help immediately. Don’t assume it’s not heart-related or that you’re not at risk because you’re a woman. “Women feel like heart attacks are more likely to occur in men, less likely to occur in them,” said Wang. “We need to break that myth.”
What can you do to protect your heart?
- Know the facts: Women get heart disease and die from it at least as often as men do.
- Manage your risk factors. Work with your doctor to manage your cholesterol, weight, blood pressure and blood sugar. Be physically active, and seek help quitting smoking if you smoke. If you have a history of depression, anxiety or pregnancy complications or started having periods at age 10 or younger, make sure your doctor knows this.
- Don’t wait to protect your heart. You’re never too young. Ask what you can do now to manage your risk for heart disease.
- Learn how heart attack symptoms may be different in women.
- If you think you might be having a heart attack, get emergency treatment right away.