What every woman should know about the risk factors and symptoms of heart disease

A woman’s heart is integral to the tapestry she creates around relationships, responsibilities, and life experiences. Yet until recently, we knew less about heart disease in women than we did about heart disease in men. In this video, meet four amazing women whose life experiences—from breast cancer treatment to pregnancy—have affected their heart health. Learn how they have benefitted from the latest heart disease research available through MedStar Heart & Vascular Institute.

Approximately one in three women in the United States has some form of cardiovascular disease, and 90 percent of women have at least one risk factor for heart disease or stroke. This contributes to a sobering fact: heart disease is the leading cause of death among American women. The good news: heart disease is largely preventable.

One of the most important steps you can take to prevent heart disease is to learn more about both the risk factors and symptoms in women.

Risk factors in women

Risk factors are aspects of your medical history, your family’s medical history, and your lifestyle that contribute to heart disease. Risk factors fall into three categories:

  • Those you cannot control
  • Those you can help manage, with your doctor’s guidance
  • Those that can contribute to heart disease that you should discuss with your doctor.

Risk factors you cannot control

Age: As women age, the risk of heart disease increases because of lower estrogen levels and the chances of developing additional health issues that can affect the heart.

Family history: You are at greater risk if an immediate family member had heart disease at an early age—55 for a male relative or younger than 65 for a female relative.

Race: African-American and Hispanic women have a higher risk of heart disease than Caucasian women.

Gender: Women have a lower risk than men of developing heart disease before menopause, but after menopause, the risk is about equal.

Risk factors you can help manage

Smoking: Smokers are two to four times more likely to have heart disease than non-smokers. When you stop smoking, your body begins to heal, and you will experience almost immediate decreases in blood pressure and heart rate.

High blood pressure: Among women of childbearing age, 20 percent have high blood pressure even though many do not realize it. The rate increases to 40 percent between ages 45 and 64, and 60 percent for those age 65 and over. High blood pressure puts added strain on the heart.

High cholesterol: About one-third of American women have cholesterol levels high enough to pose a serious heart disease risk.

Weight: Excess weight can also put added strain on your heart, raising your blood pressure, cholesterol, and glucose (sugar) levels. Another way to assess weight-related risk is to measure your waistline. For women, a waist measurement of 35” or more indicates an increased risk of heart disease.

Inactivity: Inactivity can weaken the heart, and it also makes it easier to gain weight, increasing your chances of developing other health issues, such as high blood pressure and high cholesterol.

Other risk factors to consider

Diabetes: Women with diabetes are at greater risk of heart disease than men with diabetes. Over time, high blood sugar (glucose) levels can damage the body’s blood vessels and increase the chances that fatty deposits will build up in the arteries.

Chemotherapy and radiation treatment: Radiation therapy as well as some drugs used to treat cancer, particularly breast cancer, can increase your risk of heart disease. If you have had a cancer diagnosis, talk with your doctor about seeing a cardio-oncologist, a specialist in cancer treatments and its effects on the heart.

Pregnancy complications: Women who develop high blood pressure or diabetes during pregnancy are at higher risk for developing heart disease later in life. It is particularly important for these women to see their doctor regularly for checkups each year and to pay attention to important lifestyle issues, such as exercise and healthy eating.

Stress and depression: Both chronic stress and the sudden onset of stress seem to affect women’s hearts more than men’s hearts. And people with consistently high levels of stress double their risk of heart disease—equal to the risk of high cholesterol and high blood pressure. A Sudden stressful experience, such as a loved one’s death or a bad accident, has been linked to stress-induced cardiomyopathy (broken-heart syndrome), particularly in women. And both stress and depression tend to affect a woman’s heart more than a man’s.

Sleep apnea: A serious condition in which breathing suddenly stops during the night, sleep apnea may be underdiagnosed in women. During an apnea episode, the brain triggers the body to awaken to resume breathing. This frequent, rapid awakening (which you may not even be aware of) can increase blood pressure and put added strain on your heart.

Autoimmune disease: Some of these diseases, such as lupus and rheumatoid arthritis—both more common in women than men—tend to negatively affect the heart, possibly due to the inflammation they cause.

Women’s symptoms of heart disease

While women can experience the crushing chest pain that men often describe, women’s symptoms of a heart attack—and heart disease overall—are likely to be more subtle. Here are the ABCs of women’s heart disease warning signs:

Angina (chest pain): Angina may feel like traditional pain, but it may also feel like a tightness or pressure in the chest or throat that radiates down the jaw or left shoulder or arm.

Breathlessness: Having shortness of breath or waking up breathless at night can be a warning sigh.

Chronic fatigue: Overwhelming or out-of-character fatigue may be a symptom of heart disease. Severe fatigue that lasts several days can also be a heart attack symptom.

Dizziness: Feeling light-headed or dizzy can indicate heart valve disease or arrhythmia (an irregular heart rhythm).

Edema: Swelling, particularly in the lower legs and ankles, should be assessed by a doctor.

Fluttering or rapid heartbeats: These experiences may cause pain or difficulty breathing.

Gastric upset: Talk with your doctor about nausea or vomiting unrelated to diet.

Heartburn: Some women use “heartburn” or “indigestion” to describe heart-related pain.

These symptoms do not necessarily mean that you have heart disease. But you should listen to your heart and your body. Talk with your doctor about these symptoms, what triggers them, and how long they last.

If you do have sudden chest, shoulder, or arm pain, tightness in your chest, or you have difficulty breathing, call 911 immediately. Do not delay. Getting treatment quickly could help limit damage to the heart muscle—and it could save your life.

Take a heart risk quiz just for women

To learn more about your personal heart disease risk, take this five-minute quiz designed just for women.

Take the quiz