Heart disease is the leading cause of death for about 1 in 5 women in the US, yet just over half are aware of this.
There are various types of heart disease, including coronary artery disease, heart rhythm abnormalities, heart failure, and structural abnormalities.
“Heart disease is an umbrella term that encompasses several cardiovascular conditions,” Dr. Leana Wen said.
“Coronary artery disease is the most common kind of heart disease. This occurs when the arteries in the heart are narrowed or become blocked by plaques made of cholesterol deposits. Coronary artery disease and vascular disease, or disease in blood vessels, are the leading cause of heart attacks and strokes. Risk factors for coronary artery disease include medical problems such as hypertension, high cholesterol and diabetes; obesity; and smoking.”
“Another type of heart disease is heart rhythm abnormalities. Atrial fibrillation, for instance, occurs when the heart beats irregularly. This can lead to blood clots and complications like stroke and heart failure,” she said.
“Heart failure itself is another form of heart disease. This occurs when the heart is damaged or weakened in some way. Causes of heart failure include heart attacks; chronic conditions such as high blood pressure and excessive alcohol use; and some viral or bacterial infections.”
“There are also abnormalities with the structure of the heart itself, for example, if there are defects with the valves in the heart or a hole in the wall of the heart. Some of these are congenital, meaning they are there at birth; or they could develop over time due to infection, disease or other factors,” Wen said.
Women are affected differently than men due to factors like heart size and hormonal changes.
“Studies have shown that women have a higher likelihood of developing heart disease in the smaller arteries of their heart. This is harder to diagnose compared with problems with the larger arteries and contributes in part to the higher rates of missed diagnoses in women,” Wen said.
“Furthermore, there are hormonal changes, such as changes in estrogen levels, that occur in women during their lifetime that may also affect their risk of coronary artery disease. And women are more likely than men to have certain conditions that increase their risk of heart conditions, including anemia and endometriosis.”
Pregnancy can also influence heart health. Symptoms of heart problems in women can be vague, leading to misdiagnosis.
“There are medical conditions that can manifest during pregnancy that could influence heart health both while the patient is pregnant and later in life. These include common conditions such as gestational diabetes and high blood pressure, and less common but very serious problems such as enlarged heart resulting in heart failure,” Wen said.
“There may also be preexisting heart conditions that don’t manifest until the body is stressed during pregnancy and labor and delivery. For instance, someone may have had long-standing blood pressure but not known it until pregnancy. Women of child-bearing age need to be aware of these conditions and pay attention to heart health before, during and after delivery.”
It’s important for women to manage existing medical conditions, such as high blood pressure, diabetes, and high cholesterol, and to address lifestyle factors like obesity, smoking, and stress to improve cardiac health.
“The most important thing is to be aware of and manage existing medical conditions that increase your risk of heart disease. High blood pressure is one such risk factor. More than 56 million American women have high blood pressure. That’s 44% of adult women in the United States. While the incidence of high blood pressure increases with age, many younger women have this condition, too; according to the US Centers for Disease Control and Prevention, nearly 1 in 5 women of reproductive age have high blood pressure,” Wen said.
“Fewer than 1 in 4 women with high blood pressure have this condition under control, according to the CDC. Keeping on top of your blood pressure and optimizing it with lifestyle changes and medications, if needed, is key to reducing the risk of heart attack, stroke, and other cardiovascular complications.”
“The same goes for women with diabetes and high cholesterol. Obesity is also a major risk factor, as is smoking, excessive alcohol intake, unhealthy diet and lack of exercise. Women should also not discount the role of stress, sleep, and mental well-being, which can also influence heart health.”
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