This topic is particularly important to me.
First, because I am a woman.
Second, because I have a mother whom I adore, daughters, sisters, multiple aunts, cousins and dear friends who make up my own personal super-women circle.
Third, because I have witnessed thousands of women throughout my life and career who have succumbed to this bitch of a killer – including some from that circle I mentioned.
Over 60 million women (44%) in the United States are living with some form of cardiovascular disease.1 Cardiovascular disease (CVD) includes a wide array of related diseases of the heart and vessels (including to the brain, kidneys, and elsewhere) and is the leading cause of death for women in the United States. It can affect women at any age. In 2021, it was responsible for about 1 in every 5 female deaths – with coronary heart disease (CHD) taking the lead for female mortality from all forms of CVD. 2. Research has shown that only about half (56%) of US women recognize that CVD is their number one killer.3
To conceptualize these stats: Over half of all women in the US don’t recognize cardiovascular disease as their top threat to life, even though almost half of US women have some form of it already.
Cardiovascular disease used to be viewed as a health concern predominantly affecting men. However, in the last decade or so, our attention has turned toward unveiling this once silent threat in women, dispelling the myth that CVD primarily impacts men.
We now know that CVD is the leading cause of death in women globally, surpassing all forms of cancer combined. In fact, each year, more women die from heart disease than men. Sadly, the lack of awareness continues to contribute to the under-diagnosis and under-treatment of CVD in women.
We absolutely should devote our attention to women-specific health concerns like breast cancer, ovarian and cervical cancer. But we must also focus the spotlight on the number one threat to our lives: diseases of a woman’s heart.
So, how can you decrease your risk and increase awareness for your mother, sister, daughter, spouse and friends?
First, by knowing the facts about heart disease – including the signs and symptoms. Second, by prioritizing your own health and well-being. Third, by talking openly with your healthcare provider and advocating for yourself and those you love.
Let’s face it, the system of healthcare today is lacking in time and attention for patients. Unfortunately, most of western medicine focuses more on recognition and treatment of disease and less on prevention. Knowing how to minimize risk and prevent disease must be a priority and many physicians want to help. (That’s a bit of a nuanced discussion for another time.) Luckily the culture is shifting with specialities like functional medicine and integrative medicine on the rise and some primary care providers dialing up their emphasis. But ultimately, YOU ARE IN CHARGE OF YOU and you must arm yourself with knowledge, ask the questions and seek a deeper understanding of all things you.
In my world, the chief complaint of “chest pain” accounts for approximately 7.6 million annual visits to emergency departments (ED) in the United States each year. The start of every patient encounter includes obtaining a patient’s vital signs…a quick, brief glimpse into the status of their cardiovascular system at that given time.
So, it’s fair to say that I’ve cared for many thousands of patients whose cardiovascular systems are the topic of concern.
Let’s define the term: cardio (heart) vascular (blood vessels) … therefore “cardiovascular disease” refers to diseases of the heart & vascular systems, the latter reaching every bit of the body.
If your heart is the master blood pump in the center, it may be easy to imagine that pumping against hardened, narrowed arteries or at increased resistance (high blood pressure) may wear out the pump too quickly. But that’s only half the story: the heart pump is a living muscle with its own needs for nourishment, oxygen, and waste removal. The vessels the pump fills to supply itself are the ultimate critical need; blockage equals “heart attack.”
But back to women…The unique physiology and risk factors that pertain to women make understanding and addressing cardiovascular disease in women crucial to reducing its prevalence.
Several risk factors uniquely affect women’s cardiovascular health. Some are related to reproductive factors, such as pregnancy complications like gestational diabetes and preeclampsia. Hormonal changes, particularly during menopause, also contribute to increased cardiovascular risk. Additionally, social and behavioral factors irrespective of gender, such as stress, sedentary lifestyle, poor nutrition, and smoking, can significantly impact women’s heart health.
Aside from mitigating risk and lifestyle optimization, it’s important to increase awareness of the signs and symptoms to ensure timely detection and intervention.
Heart attacks in women often present differently than what you might picture in your mind. In fact, it’s pretty unusual for me to see a patient with that classic presentation – an overweight man, sweating and clutching his chest, pale and breathing heavily. Yes, this “classic” presentation exists, but more commonly, especially in women, it might look much different. In women, it can be more subtle…their symptoms can be deceiving.
Fatigue, nausea, vomiting, shortness of breath, jaw pain, back pain, some exercise intolerance or loss of stamina – these may be easily mistaken for other conditions and brushed off as “aches and pains” or “exhaustion.” This can lead to delayed diagnosis and, consequently, poorer outcomes.
So, if you or a woman you know experience these symptoms – particularly if they are not easily explained or they persist – please, don’t ignore them. Seek medical attention early. The old adage “better to be safe than sorry” applies here. If you can’t get in to see your doctor, you are always welcome in the emergency department.
With signs and symptoms covered, let’s return to prevention.
To combat cardiovascular disease in women effectively, a multi-faceted approach is required. First and foremost, increasing your self-awareness, tuning into your mind-body connection can help you recognize red flags more quickly when they first appear. Need a quick primer on mindfulness? Search back through some of our earlier blog posts.
After that, engaging in regular exercise, opting for a heart-healthy diet, quitting smoking and undergoing regular check-ups with your healthcare provider are some of the preventive measures and lifestyle changes that can significantly reduce your risk of CVD.
Engaging in physical activity for at least 150 minutes per week can have significant cardiovascular benefits. While more may be better, almost anything compared to next-to-nothing has a significant effect. Activities such as brisk walking, jogging, swimming, or cycling are excellent choices. Moving your body has so many other beneficial effects on your overall well-being.
Opting for a diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats (like those found in avocados and nuts) and limiting the intake of processed foods, saturated fats, salt, and added sugars is also essential.
If you smoke, talk to your healthcare provider about assistance with quitting. Even starting by cutting down will have an effect. Quitting smoking is one of the most impactful steps towards improving heart health.
Along with establishing a mindfulness practice, engaging in enjoyable hobbies, spending time in healthy relationships or seeking therapy when needed, and achieving better sleep can help mitigate the effects of long-term stress and reduce the risk of CVD.
Finally, as mentioned, all women should have regular check-ups with their healthcare provider, including screenings for blood pressure, cholesterol levels, and diabetes. These screenings can help identify potential cardiovascular risks.
Ok, that was a lot to digest.
Hopefully you feel armed with more knowledge and a deeper understanding of this often underestimated and misunderstood threat to women’s health. Understanding the unique symptoms, risk factors, and preventive measures specific to women is crucial for early detection and effective intervention.
By prioritizing cardiovascular health, raising self-awareness, and adopting a healthy lifestyle we can collectively combat this silent killer and empower women to lead heart-healthy lives.
Remember, you are in charge of you and knowledge is the first step towards prevention.
Now, go spread the word!
Let’s be well, together.
1. Tsao CW, Aday AW, Almarzooq ZI, et al. Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association [published online ahead of print, 2023 Jan 25]. Circulation. 2023;
2. National Center for Health Statistics. Multiple Cause of Death 2018–2021 on CDC WONDER Database. Accessed February 2, 2023.
3. Mosca L, Hammond G, Mochari-Greenberger H, Towfighi A, Albert MA, American Heart Association Cardiovascular Disease and Stroke in Women and Special Populations Committee of the Council on Clinical Cardiology, Council on Epidemiology and Prevention, Council on Cardiovascular Nursing, Council on High Blood Pressure Research, and Council on Nutrition, Physical Activity and Metabolism. Fifteen-year trends in awareness of heart disease in women: Results of a 2012 American Heart Association national survey. Circulation. 2013;127(11):1254–63, e1–293
For more information, visit CDC.gov