Women’s Heart Health: How It’s Different From Men’s
eart disease is the leading cause of death for women, killing one woman nearly every minute. More women die from coronary heart disease than from any cancer.
Women’s Risk Factors for Heart Disease
While women and men share some of the same risk factors for heart disease, such as smoking, obesity, high blood pressure, family history, metabolic syndrome, etc., women also have unique risks. For example, high blood pressure and diabetes are heart disease risk factors for both genders. However, for women, these two conditions put women at more significant risks for heart disease than for men.
In separate studies, Ohio State University Medical Center in Columbus and John Hopkins School of Medicine in Baltimore, Maryland found these women-specific heart disease factors:
- Blocked arteries in the legs (peripheral artery disease)
- Depression and stress
- High testosterone levels before menopause
- Increasing high blood pressure during menopause
- Autoimmune diseases, such as rheumatoid arthritis
- Lack of awareness to the above conditions raise risk factor for heart disease.
Ethnicity also plays a role: African-American and Hispanic women are at a higher risk of developing heart disease than other ethnic groups. Forty-nine percent of African-American women over 20 years old have heart disease. Also, black women are less likely to be recommended for treatment, such as bypass surgery.
Women and Heart Attacks
Sixty-four percent of women who have died from heart attacks had no previous symptoms. Some of it can be attributed to the fact that many women don’t seek medical attention for a heart attack because they are frightened and put their families before themselves, says Dr. Nieca Goldberg, the medical director for Joan H. Tisch Center for Women’s Health at NYU’s Langone Medical Center.
Heart attacks happen when the arteries to the heart become wholly or partially blocked with a buildup of cholesterol, fat, and plaque. According to Laxmi Mehta, M.D, author of a recent study on heart attacks and women points out several differences in women and men who have heart attacks. For one, she says plaque can forms differently in women.
Plaque in some women and especially younger women doesn’t bulge in the arteries in a way that is detectable and so makes it hard to discover on routine tests. Also, stents that are the typical treatment to open blocked arteries are not useful for this type of plaque buildup.
She also found in her research that:
- After a heart attack, women with substantial artery obstruction may not receive the therapies and medicines they need.
- Women are undertreated for heart disease.
- Women wait longer than men to seek treatment. Men delayed seeking help for 16 hours whereas women waited 54 hours.
Even after surviving a heart attack, women tended to have more complications while in the hospital like bleeding, heart failure, and shock. Also, women were less likely to take prescribed medications or participate in cardiac rehabilitation.
Heart Attack Symptoms
Heart attack symptoms in women often go unrecognized. For many decades, there was one set of symptoms for a heart attack based on men’s experiences. The assumption was they were the same for women.
However, in recent decades new studies show that women can have different heart disease symptoms. For example, it’s typical for men to have the feeling of an elephant on their chest during a heart attack. While this can also be a symptom for women, they may have a heart attack without the chest pressure.
Heart attack signs can vary from person to person. For example, some women after having a heart attack said they thought they had the flu or acid reflux. In other words, women may have subtle signs that signal a heart attack.
As mentioned, while the most common sign of a heart attack is chest pain or discomfort, not all women will experience it. Other symptoms include:
- Shortness of breath that feels like you’ve run a marathon, but you haven’t moved
- Upper back pressure that feels like a rope is being tied around you or a tight squeezing feeling
- Nausea or vomiting
- Back jaw pain
- Squeezing or fullness in the chest center that lasts for a few minutes or goes away and comes back
- Feelings of anxiety
- Pain or pressure in the lower chest or upper abdomen
- Lightheadedness or fainting
- Pain in the chest, neck, shoulders, and upper back
- Unexplained fatigue, weakness, or dizziness
- Flu-like symptoms, clamminess, or a cold sweat Heart Association.[i]
Since heart disease is the leading cause of death for women, it’s important for women to work with their primary care practitioner to learn their risks. In addition, women need to be proactive when it comes to having symptoms that are out of the ordinary and seek medical attention quickly.
Barouch, Lili, M.D. Heart Disease: Differences in Men and Women. https://www.hopkinsmedicine.org/heart_vascular_institute/clinical_services/centers_excellence/womens_cardiovascular_health_center/patient_information/health_topics/heart_disease_gender_differences.html.
Heart attacks in women undertreated, expert say (January 25, 2016). Retrieved from http://www.heart.org/en/news/2018/05/01/heart-attacks-in-women-undertreated-experts-say
Heart Attack Symptoms in Women. Retrieved from http://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack/heart-attack-symptoms-in-women
[i] Heart Attack Symptoms in Women. Web