Women & Heart Disease

Historically, women’s health has often been viewed through the lens of reproductive health, overlooking other
critical aspects of women’s health, particularly heart disease. This has contributed to significant gaps in the
understanding, diagnosis, and treatment of heart disease in women. Raising awareness and improving education on
heart disease in women is crucial for early recognition and treatment.

Women and Heart Disease: Key Facts

• Heart Disease vs. Breast Cancer: For every woman who dies from breast cancer, six
  women die from heart disease. Despite widespread awareness of breast cancer, heart disease remains
  the leading cause of death in women.
• Young Women at Higher Risk: Younger women (under 55) are twice as likely to
  die from a heart attack compared to younger men. Additionally, heart disease in younger women often goes
  unrecognized, leading to higher mortality rates.
• Prevalence:
  • Ages 45-64: 1 in 9 women has heart disease.
  • Ages 65 and older: 1 in 3 women has heart disease.
• Misdiagnosis and Delayed Treatment: Heart disease symptoms in women are often dismissed or
  attributed to aging. Women are also more likely to delay seeking treatment during a heart attack.
  
  
  

Why Heart Disease in Women is Different

• Smaller Arteries: Women’s heart arteries are smaller, which may make heart disease more
  difficult to detect and treat.
• Atypical Symptoms:
  • 71% of women experience atypical heart attack symptoms such as nausea or vomiting, flu-like symptoms,
    upper abdomen discomfort, shortness of breath, fatigue, dizziness. These symptoms often occur without
    chest pain, which can delay recognition and treatment.
• Different Response to Treatment: Women may respond differently to heart disease treatments like
  aspirin, and traditional diagnostic tests often yield more false results in women.
• Breast Cancer Therapy Risks: Treatments for breast cancer, including chemotherapy and
  radiation, can increase the risk of heart disease. Women who have undergone breast cancer treatment need ongoing
  heart monitoring, as their risk for heart disease remains elevated.
  
  
  

Shared Risk Factors for Heart Disease in Men and Women

• Age (Men > 45 years, Women > 55 years)
• Hypertension (Blood pressure > 140/90)
• Diabetes
• High LDL cholesterol (“bad” cholesterol > 160)
• Low HDL cholesterol (“good” cholesterol: < 40 in men, < 50 in women)
• High triglycerides (> 150)
• Family history of heart disease
• Smoking
• Obstructive Sleep Apnea (OSA)
• Metabolic syndrome
  
  
  

Specific Risk Factors for Women

• Anemia
• Early Menopause
• Chronic Inflammatory Diseases:
  • Conditions like rheumatoid arthritis, lupus, and polycystic ovary syndrome (PCOS) increase the risk of
    heart disease.
• Kidney Disease
• Thyroid Disease
• Low Bone Density
• Psycho-Social Factors: Stress, anxiety, and depression can significantly increase the risk of heart disease in
  women.
  
  
  

Cardio-Oncology: How Cancer Affects the Heart

Cancer treatments such as chemotherapy and radiation therapy increase the risk of heart disease (HD). This risk
remains elevated even after cancer is cured. Regular cardiac monitoring is crucial for cancer survivors to detect
and prevent heart complications related to their treatments.

Heart Disease Diagnostic Tools for Women

• Angiogram: Used to check for blockages in the arteries.
• Echocardiogram: Ultrasound of the heart to evaluate its structure and function.
• Stress Test: Women often experience a higher rate of false positives during stress tests. Adding imaging agents
  such as nuclear imaging can improve accuracy.
• Carotid and Leg Ultrasounds: Assess blood flow in the neck and legs to detect signs of atherosclerosis.
• CT Angiography with Calcium Scoring: Helps assess plaque buildup in the coronary arteries.
  
  
  

Where Do We Go from Here?

• Acknowledge the High Incidence of Heart Disease in Women: Heart Disease is the No. 1 Killer of
  Women.
• Recognize that women often experience atypical symptoms and face challenges in diagnosis.
• Understand that women typically have worse outcomes after heart attacks compared to men.
• Recognize Unique Risk Factors in Women: Be aware of specific conditions such as early
  menopause, autoimmune diseases, and psychosocial factors that increase heart disease risk in women.
• Prevention and Advocacy: Be proactive about heart health. Recognize the signs of heart disease
  and advocate for appropriate testing and early treatment. Aggressive risk factor modification is key. Manage
  blood pressure, cholesterol, and lifestyle factors like diet, exercise, and smoking cessation.
• Stay Informed and Monitored: Early detection is essential for improving survival rates. Regular
  check-ups and screenings are important for women at risk.
  
  
  

Summary:

Heart disease is the leading cause of death in women, yet it is often under-recognized and under-treated. Women can
experience atypical symptoms and have unique risk factors that make diagnosis more difficult. Raising awareness
about the differences in how heart disease affects women, improving diagnostic tools, and addressing gender biases
in treatment are critical steps toward reducing heart disease in women. Advocate for your heart health, know the
risk factors, and seek timely care to improve outcomes.