Women's Heart Health: Risks, Symptoms & Prevention

Let’s set the record straight—women have been marginalized in many areas throughout history, including the world of medical research. What you might not know is that, for decades, scientific health studies primarily relied on white male participants, often excluding women from critical research. This oversight is significant because, biologically, men and women function quite differently. Our brains are different, our hormones are different, and our bodies have unique needs that deserve attention.

In this blog post, Associate Professor and Cardiologist Iveta Mintale shares invaluable insights about women’s heart health and why it’s crucial to address these differences in medical science.

Science has identified significant biological differences between men and women, including differences in the manifestation of cardiovascular diseases (CVDs).
Traditionally, the symptoms of heart diseases in men have been classified as “typical,” whereas the different symptoms in women have been labeled as “atypical.” This approach has delayed accurate diagnosis and timely treatment for women with cardiovascular diseases for years.
Cardiovascular diseases are the leading cause of death in women, far surpassing deaths from all forms of cancer combined. Despite this, women often fail to recognize the risks of heart disease, largely because societal focus leans more heavily on the fear of cancer.

It is the responsibility of healthcare professionals to educate and emphasize prevention, as 80-90% of cardiovascular diseases are preventable through optimizing cardiovascular health and mitigating risk factors.

Common Risk Factors for Cardiovascular Diseases

Risk factors like

smoking, high cholesterol, diabetes, sedentary lifestyles, unhealthy diets, high blood pressure, and obesity 

are common to both men and women. However, smoking, diabetes, lack of exercise, and obesity are even more critical risk factors for women.

Specific Risk Factors for Women

Women also face unique cardiovascular risk factors, including early menopause (before age 50), inflammatory diseases like lupus and rheumatoid arthritis, and pregnancy complications. Pregnancy serves as a “stress test” for the vascular system, offering insights into future risks. Complications such as high blood pressure, gestational diabetes, preeclampsia, or preterm birth significantly increase the risk of future cardiovascular diseases.

Chronic stress, insufficient sleep (less than six hours a night), and depression are additional risk factors. Depression doubles the risk of heart attacks and cardiovascular death in women under 55. Furthermore, a family history of heart conditions, such as heart attacks or strokes before age 55, significantly elevates a woman’s risk.

Symptoms of Heart Diseases in Women

Women often exhibit “atypical” symptoms of heart disease, such as fatigue, shortness of breath, chest discomfort, palpitations, sweating, or irregular heartbeats. These differ from the “classic” symptoms like crushing chest pain often seen in men.

Challenges in Diagnosis and Research

Historically, women were underrepresented in research studies on cardiovascular diseases. As a result, findings derived from male populations were inaccurately applied to women, labeling their symptoms as “atypical”. This led to delayed diagnoses and treatments. Today, functional tests such as stress tests have regained importance in diagnosing heart diseases in women.

Key Diagnostic Tools for Women

• Stress Echocardiography: Recommended for symptomatic women at moderate risk.

• Myocardial Perfusion Scintigraphy (SPECT): Useful for evaluating ischemia in women.

• CT Angiography: Effective for symptomatic women with inconclusive stress test results.

• Cardiovascular MRI: Provides valuable insights, especially for microvascular diseases.

Anatomical Differences in Coronary Artery Disease

Women often have smaller blood vessels, more diffuse atherosclerosis, and microvascular disease. These differences necessitate a personalized approach to diagnosis and treatment.

Prevention is Key

90% of women have at least one cardiovascular risk factor, but 80% of these can be managed through lifestyle changes: avoiding smoking, regular exercise, maintaining a healthy diet, and managing body weight.

Know Your Numbers:

• Blood pressure: Below 120/80 mmHg

• Blood sugar: <6 mmol/L

• Cholesterol: LDL below 2.6 mmol/L for low-to-moderate risk and <1.4 mmol/L for high risk.

Maintaining heart health starts with self-awareness and prevention. Collaborative efforts between cardiologists, general practitioners, and gynecologists can improve early diagnosis and risk management.