An American Heart Association survey taken several years revealed that women tend to underestimate their risk of heart disease and mistakenly believe th The Threat and Signs of Heart Disease in Women | Heart Disease Symptoms and Diagnosis | Imaginis - The Women's Health & Wellness Resource Network

The Women's Health Resource. On the web since 1997.

The Threat and Signs of Heart Disease in Women

An American Heart Association survey taken several years revealed that women tend to underestimate their risk of heart disease and mistakenly believe that they are are greater risk of dying from other disease, such as breast cancer (click here to read about the survey). However, it is important to note coronary artery disease is the number one cause of death in the United States among both men and women.

Nearly 500,000 (one-half million) American women die of cardiovascular disease each year. This is twice the number of deaths from all cancer combined; lung cancer, the leading cause of cancer deaths, claims approximately 65,000 deaths per year, and breast cancer kills around 40,000 women. Other statistics from the American Heart Association:

  • One in three women have some form of cardiovascular disease.
  • Since 1984, women's deaths from cardiovascular disease have exceeded deaths in men.
  • Each year, 55,000 more women have strokes than men (due to the longer life expectancy among women).

As a woman ages, her risk of heart disease increases: about 9,000 American women under age 45 have heart attacks each year versus about 250,000 women over age 65. Medical experts are unsure why the risk of heart disease increases in older women but some believe it may be related to the depletion of the female hormone estrogen at menopause.

As men age and their arteries become blocked, the body develops new arteries to serve as back-up blood routes; these back-up routes are called collateral blood supplies. However, women do not develop these collateral blood supplies as they age since, with estrogen, their blood vessels can expand to accommodate blockage. Thus, the thought is that when a woman's estrogen production decreases significantly at menopause, her arteries tend to lose their flexibility and her risk of heart disease increases significantly since no collateral blood supply is developed. This may also explain why more women are likely to die within a year of a heart attack than men.

Many of the risk factors for heart disease are the same for women and men. These risk factors include: high blood pressure, high cholesterol, diabetes, high fat diet, excessive weight, lack of physical activity, smoking, and a family history of heart disease. However, other risk factors for women include menopause (specifically, loss of estrogen at this time) and the use of oral contraceptives among smokers or those with high blood pressure.

Women also tend to have different heart attack symptoms than men. The following chart summarizes these differences:

Heart Attack Symptoms

In Both Men and Women

More Often in Women Only

  • Pain/squeezing in middle
    of chest
  • Shooting pain/numbness
    in left arm
  • Sweating/nausea
  • Pain in the back, neck,
    or other areas
  • Exhaustion/shortness of breath
  • Stomach upset/indigestion
  • Feelings of anxiety

Preventing Cardiovascular Disease

While no preventive measure can eliminate the chances of developing heart disease, the U.S. government has issued guidelines in an effort to aggressively treat and prevent heart disease in millions of Americans. In addition to more emphasis on low-fat diets and exercise, the guidelines call an estimated 36 million to take cholesterol-lowering drugs.

The guidelines include:

  • Treating patients with at least a 20% risk of having a heart attack in 10 years as aggressively as those who already have heart disease.
  • Treating high cholesterol more aggressively in people with diabetes.
  • Using a lipoprotein profile as the first test for high cholesterol.
  • Modifying the current HDL ("good") cholesterol level guideline to 40 mg/dL.
  • Emphasizing the need for nutrition, exercise, and weight control in treating high cholesterol.
  • Identifying people with "metabolic syndrome" and treating them aggressively to prevent heart attacks (a condition characterized by abdominal obesity, high triglycerides, high blood pressure, high blood-sugar levels, and low HDL ("good") cholesterol)
  • Treating people with high triglyceride levels more aggressively.
  • Advising to take cholesterol-lowering drugs to lower cholesterol instead of hormone replacement therapy (the American Heart Association recently endorsed this recommendation too).

 Click here learn more about these guidelines.

Additional Resources and References

Updated: February 2011