How common is heart disease in women? Check details here

Heart disease in women: Cardiovascular disease affects women and people designated female at birth (DFAB) in unique ways. Differences between the sexes like anatomy, the number of red blood cells and hormones seem to impact the experience of cardiovascular disease in men and women.

It was a popular misconception that heart disease was mostly a male problem. That was because men more often adopted behaviours which increased the risk of heart and blood vessel disease. Prior to menopause, hormonal influences were protective in women. A male-dominated medical research enterprise designed and tested diagnostic tools in men only and later inappropriately applied them to women, often missing the signs and symptoms of heart disease in women.

Cardiovascular disease (CVD) is the leading cause of death in the U.S. and around the world. In 2019, cardiovascular disease caused 1 in 3 deaths around the world. That’s almost 18 million people who died from CVD that year alone. In the U.S., about 1 in 4 deaths are caused by heart disease — around 659,000 each year. According to studies, it’s responsible for about 1 in 4 female deaths each year.

Types of heart disease in women and men

Heart disease is also called cardiovascular disease. It includes several different conditions that can affect the heart and blood vessels. These include:

• coronary artery disease (blockages in the blood vessels around the heart)
• peripheral artery disease (blockages in the blood vessels in the arms or legs)
• problems with your heart’s rhythm (arrhythmia)
• problems with your heart’s muscles or valves (valvular heart disease)
• congestive heart failure (problem with the pumping or relaxation functions of the heart muscle)
• coronary vasospasm (sudden contractions of an artery wall)
• coronary microvascular disease (problems with the small blood vessels that branch off from the coronary arteries)
• heart failure with a reduced ejection fraction (the inability of one of the heart’s chambers to contract properly)

These conditions may develop over time, or they may be a result of structural issues with the heart before birth, called congenital heart disease.

The Centers for Disease Control and Prevention (CDC) says that approximately 6 percent of U.S. women over age 20 have coronary heart disease or coronary artery disease, which is the most common type. The risk of heart disease increases with age.

How is the cardiovascular system different in women and men?

Researchers have found many sex-related differences in the cardiovascular system. These complex differences, often at a microscopic level, can affect how women and men experience heart disease. A few examples include:

• Anatomy: Women have smaller blood vessels and heart chambers. The walls of their ventricles are also thinner.
• Blood count: Women have fewer red blood cells. As a result, women can’t take in or carry as much oxygen at any given time.
• Cardiovascular adaptations: Changes in altitude or body position (like quickly standing up after lying down) affect women more than men. Women are more likely to have sudden drops in blood pressure or faint.
• Hormones: Estrogen and progesterone dominate in women, while testosterone dominates in men. These hormones can impact many aspects of heart health and overall health.

Symptoms of heart disease in women

Women usually notice symptoms of cardiovascular disease about 10 years later than men do. For a heart attack, chest pain or discomfort is the most common symptom for everyone. But there are some important differences that affect women and people DFAB.

Women and people DFAB are more likely to have some other type of heart attack symptom, in addition to generalized chest pain (or instead of it). Also, they’re at a higher risk of having a silent heart attack. This is a heart attack that shows no obvious symptoms. Women over age 65 are more likely to die from a silent heart attack than men over age 65.

One reason that women may not pay as much attention to a heart attack could be due to their symptoms. Women are more likely to experience nontraditional heart attack symptoms compared with men. Also, their symptoms tend to come on more gradually.

Some of the most common heart attack symptoms for women include:

• chest pain that feels like tightness or pressure, instead of the more severe chest pain that men often feel — however, in some cases, there may be no chest pain at all
• extreme or unusual fatigue that could develop before other symptoms and may feel like you’re coming down with the flu
• throat and jaw pain, many times without any chest pain
• pain or discomfort in the upper abdomen that could feel like indigestion or heartburn
• pain, discomfort, or a tingling sensation in one or both arms
• upper back pain that may have a burning, tingling, or pressure-like feeling
• light-headedness or dizziness
• nausea and vomiting
• changes in skin color, such as grayish skin
• sweating
• shortness of breath

More symptoms may become apparent as heart disease progresses. Symptoms can differ depending on what specific type of heart disease you have.

The symptoms of heart disease in women are also different from those in men, who are more likely to have chest pain.

Potential later symptoms of heart disease in women include:

• swelling in your legs, feet, or ankles
• weight gain
• problems sleeping
• your heart feeling like it’s beating very fast (heart palpitations)
• coughing
• wheezing
• sweating
• lightheadedness
• indigestion
• heartburn
• anxiety
• fainting

Risk factors for heart disease in women

The risk factors of heart disease in women increases with various factors. Some of the factors are mentioned below.

• Menopause: Women can develop heart disease at any age, but the risk increases after periods stop, usually by age 55. Before menopause, the body makes more estrogen (a female hormone) which helps protect against heart disease. That’s why women generally develop coronary artery disease 10 years later than men. During and after menopause, estrogen levels drop and the risk for heart diseases goes up. If a woman’s periods stop before age 40, the risk will be higher than other women the same age.
• Family history of heart disease: The risk for heart disease may be higher if:
  • Mother or sister had heart disease before age 65.
  • Father or brother had heart disease before age 55.
• Problems during pregnancy: These include high blood pressure, gestational diabetes, anemia, etc.
• Use of hormonal birth control: Pills, patches, or vaginal rings with estrogen and progesterone might affect heart health of women.
• Endometriosis.
• Polycystic ovary syndrome.
• Inflammatory and autoimmune diseases.
• Metabolic syndrome.
• Mental health issues, such as stress, anxiety, or depression.
• Health risks from a lack physical activity.
• Obesity or being overweight.
• Diabetes.
• Low HDL cholesterol levels.
• Mild to moderate high blood pressure.
• Smoking.

In the presence of one or more of these risk factors, a health care provider should be consulted for any possible precautions that could be taken to lower the risk of heart diseases.

NOTE: The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.