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Women's Cardiovascular Health

Doctor examining a women's heart with a stethoscope.

Cardiovascular diseases remain the most common cause of death among women. In the U.S., approximately one in four women die each year due to cardiovascular diseases. “Though trends are improving, a majority of women remain unaware of their risk,” says Bina Ahmed, MD, FACC, Interventional Cardiology at Dartmouth-Hitchcock Medical Center.

To ensure optimal cardiovascular health, it is important to understand the risk factors and discuss them with your primary care provider. “The priorities remain raising awareness so that women are paying attention to their overall cardiovascular health when it counts the most. In addition, we need to continue efforts toward funding research that helps us understand potential differences between men and women and the various cardiovascular disease like coronary artery disease and stroke,” says Ahmed.

What is heart disease?

Heart disease specifically refers to coronary artery disease, which is due to plaque build-up in the coronary arteries, the primary arteries that supply blood, oxygen and nutrients to the heart. The most common cause of a heart attack usually is a sudden blockage of one or more of the heart arteries. Though the majority of women present with predictable symptoms such as chest pain, women can present with less typical associated symptoms such as nausea, shoulder/back pain or shortness of breath. Most heart attacks if diagnosed in a timely manner, can be treated.

There are other cardiovascular diseases like stroke, heart failure and hypertension, which also are a concern for women, especially after menopause.

What are the main risk factors for heart disease?

  • High blood pressure
  • High cholesterol
  • Obesity
  • Inactivity
  • Smoking
  • Diabetes

According to the Centers for Disease Control (CDC) “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.”

While the main risks are similar to those for men, women need to be particularly aware of them starting in the perimenopause (roughly between ages 40-60). As women age, the likelihood of developing heart disease associated with one of these factors increases, so preventing, controlling and treating them becomes vital.

One particular risk factor to highlight among women is diabetes. “Diabetes is considered the risk equalizer for heart disease among women; especially among younger women. Younger women with diabetes are at an increased risk of sudden heart attacks and consequently tend to have the worst long-term outcomes,” says Ahmed. Women with diabetes likely have other risk factors such as obesity, high blood pressure and high cholesterol, which compounds their problem. More aggressive therapies, which optimize diabetes and blood pressure control, in addition to adopting a healthier lifestyle, are very important.

How can you protect your heart health?

  • Manage high blood pressure - According to the CDC, “about one of three U.S. adults—or about 75 million people—have high blood pressure,” a condition that occurs when the force of blood flowing through your body is too high. High blood pressure hardens the arteries, causing decreased blood flow and can ultimately damage your heart, brain and kidneys.
  • Control cholesterol - Cholesterol is a substance made and used by your body to create cells and hormones, but producing too much can cause build-up in the heart’s arteries, resulting in blockages. While cholesterol is produced by your body, you get a substantial amount of the “unhealthy” cholesterol by consuming foods high in fat. Eating healthy is the first line of defense against high cholesterol.
  • Maintain a healthy weight - Being overweight or obese increases the risk of developing heart disease. Ask your doctor to help determine a healthy weight for you.
  • Stay active - An active lifestyle helps you maintain a healthy weight and it can help to lower blood pressure and cholesterol. According to the CDC, “the Surgeon General recommends two hours and 30 minutes of moderate-intensity exercise, like brisk walking or bicycling, every week.”
  • Stop smoking - Smoking damages the lining of blood vessels, thickens the blood, making it more likely to clot, and increases build-up of plaque (fat, cholesterol, calcium and other substances), which can block or restrict blood flow.

While risk factors such as inactivity and smoking are personal choices, other conditions such as high blood pressure or high cholesterol could be due to age or genetics. “In these instances, early diagnosis can be lifesaving. Many treatments are available to help effectively lower the risk of cardiovascular diseases such as heart attacks,” says Ahmed. “In addition, lifestyle therapy with diet and exercise can make a significant difference.”

Stay Informed by talking with your doctor

Dr. Ahmed emphasizes the importance of being engaged and keeping communications open with your provider. Have a conversation about your cardiovascular health and ask:

  • “What is my cardiovascular risk?”
  • “Are my blood pressure, cholesterol and weight within appropriate standards?”
  • “How can I improve my risk of cardiovascular diseases?”

The American Heart Association’s website,, is a great resource for up-to-date information on Heart Health. You can even check your heart health score at My Life Check.