Heart disease is the number one killer of women, causing one in three deaths each year — about one woman every minute. But it doesn’t affect all women alike, and the warning signs for women aren’t the same in men. What’s more, most women greatly underestimate their risk of heart disease and may be missing out on key opportunities for prevention.
Historically, heart disease and heart attacks have typically been associated with men. Consequently, most research in this area has focused on men, and as a result, a distorted picture of heart disease and risk has formed, with women’s needs being ignored and awareness of their risk overlooked.
The American Heart Association’s Go Red For Women movement advocates for more research and swifter action for women’s heart health for these very reasons. The association picked red because it’s the color of our hearts. The color red also represents strength, joy and power, and during American Heart Month in February, it symbolizes the fight against heart disease in women.
Below are ten things that all women should know about heart disease – because the truth can no longer be ignored.
1. Heart disease kills several times as many women each year as breast cancer
Women’s age-adjusted mortality rates from heart disease are four to six times higher than their mortality rates from breast cancer. In fact, according to the AHA, heart disease is more deadly than all forms of cancer combined.
Because most public awareness campaigns have emphasized breast cancer risk in order to promote mammography screening, many women are more afraid of breast cancer than heart disease; only about 1 in 5 American women believes that heart disease is her greatest health threat.
2. Women don’t usually display “classic” heart attack symptoms
Warning signs of a heart attack for women are not the same as men, which may be why women are less likely to call 911 when experiencing symptoms of a heart attack.
Symptoms of concern for women include:
- Neck, jaw, shoulder, upper back or abdominal discomfort
- Shortness of breath
- Right arm pain
- Nausea or vomiting
- Lightheadedness or dizziness
- Unusual fatigue
These symptoms can be more subtle than the obvious crushing chest pain often associated with heart attacks. Women may describe chest pain as pressure or a tightness. This may be because women tend to have blockages not only in their main arteries but also in the smaller arteries that supply blood to the heart — a condition called small vessel heart disease or microvascular disease. 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.
3. Even if you have no symptoms, you may still be at risk for heart disease.
Almost two-thirds (64 percent) of women who die suddenly of coronary heart disease have no previous symptoms of the disease. That’s why it’s so important to know your risk factors, including your family history.
4. Women are more likely than men to die of heart disease and heart attack
Since 1984, more women than men have died each year from heart disease. That’s partly because even doctors overlook women’s risk of heart disease. When women go to the emergency room with signs of a heart attack, they are significantly more likely than men to be misdiagnosed and sent home without any treatment. As a result, women are also significantly more likely than men to die of their first heart attack.
5. Nine out of ten women have one or more risk factors for developing heart disease.
High blood pressure, high LDL cholesterol, and smoking are key risk factors for heart disease. About half of Americans (49 percent) have at least one of these three risk factors.
Several other medical conditions and lifestyle choices can also put people at a higher risk for heart disease, including:
- Overweight and obesity
- Poor diet
- Physical inactivity
- Excessive alcohol use
According to the AHA, at least 90 percent of American women have one or more of these risk factors.
6. Heart disease affects women of all ages.
Currently, about 35,000 women under the age of 65 are living with heart disease. Of the 435,000 American women who suffer heart attacks annually, 83,000 are under age 65 and 35,000 are under 55.
For younger women, the combination of birth control pills and smoking boosts heart disease risks by 20 percent. And while the risks do increase with age, things like overeating and a sedentary lifestyle can cause plaque to accumulate and lead to clogged arteries earlier in life. But even if you lead a completely healthy lifestyle, being born with an underlying heart condition can be a risk factor.
7. African American women have a particularly high risk of heart disease
The prevalence of heart disease is higher among African American women than women of any other race/ethnicity. Of African American women ages 20 and older, 46.9 percent have cardiovascular disease. African American women are also more likely to die of heart disease. What’s more, African-American women have almost two times the risk of stroke than white women, and are more likely to die at an earlier age when compared to women of other racial/ethnic groups.
Researchers have found that there may be a gene that makes African-Americans much more sensitive to the effects of salt, which in turn increases the risk for developing high blood pressure. In people who have this gene, as little as one extra gram (half a teaspoon) of salt could raise blood pressure by as much as five millimeters of mercury (mm Hg). African-Americans also tend to have higher rates of obesity and diabetes, which puts them at greater risk for high blood pressure and heart disease.
8. Women are underrepresented in heart disease research
Women comprise only 24 percent of participants in all heart-related studies. The statistics aren’t much better for randomized trials of new drugs and treatments: Overall, the 62 randomized clinical trials published between 2006 and mid 2009 enrolled 380,891 participants, but only 127,716 of them were women — about 33.5 percent. In some trials, women comprised as little as 15 percent of participants. What’s more, only 50 percent of clinical trials report the analysis of the results by gender, making it impossible for researchers to assess critical gender differences.
9. Women are also underrepresented in heart disease prevention and treatment
Although women make up more than 50 percent of heart disease-related deaths, they make up only 25 percent of bypass patients and 30 percent of heart transplant patients. After heart attack, women are less likely than men to receive beta blockers, ACE inhibitors and aspirin – therapies known to improve survival. This contributes to a higher rate of complications after heart attacks in women, even after adjusting for age. And even though women’s hearts respond better than men’s to healthy lifestyle changes, only 2 percent of the NIH budget is dedicated to prevention.
10. There are steps all women can take to reduce heart disease risk
While these statistics are certainly dire, it’s important to remember that most risk factors for heart disease are modifiable — which means we can change them to lower our risk. To reduce your chances of getting heart disease it’s important to:
- Know your blood pressure. Having uncontrolled blood pressure can result in heart disease. High blood pressure has no symptoms so it’s important to have your blood pressure checked regularly.
- Talk to your healthcare provider about whether you should be tested for diabetes. Having uncontrolled diabetes raises your chances of heart disease.
- Quit smoking.
- Discuss checking your cholesterol and triglycerides with your healthcare provider.
- Make healthy food choices. Being overweight and obese raises your risk of heart disease.
- Limit alcohol intake to one drink a day.
- Lower your stress level and find healthy ways to cope with stress.