Heart Attacks and Women

February is American Heart Month, a time to focus on the importance of cardiovascular health in everyone, but particularly in women. According to the National Heart, Lung and Blood Institute (NHLBI), heart disease remains the leading cause of death in both men and women in the United States and worldwide. The NHLBI and the American Heart Association also report that heart disease kills one out of four women in the United States.

There are traditional risk factors for heart disease that affect women as well as men. These include increasing age, high cholesterol, high blood pressure, tobacco use, family history of heart disease, poor diet and lack of exercise. In addition, there are factors unique to women which place them at elevated risk for heart disease. These include hormonal factors (premature menopause, hormonal therapy during menopause and polycystic ovarian syndrome) as well as pregnancy-related adverse outcomes and autoimmune disorders, both of which increase the risk of heart disease in women.

Recognize the warning signs.

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Everyone recognizes the universal presentation of a heart attack—a man or woman clutches their chest in pain and falls to the ground. But women don’t always follow this script. Women are more likely to have atypical or subtle symptoms during a heart attack, which may include:

• Pain in a different location. Pain or discomfort in your neck, back, jaw or stomach. 
• Nausea. Feeling sick to your stomach or vomiting.
• Shortness of breath. Having a hard time breathing, even when sitting down.
• Fatigue. Feeling tired for a long time without a clear cause.

If you suspect you might be having a heart attack, call 911 right away. Time is an important factor in the management of heart disease. The longer a heart attack remains untreated, the more at risk the heart muscle can be.

Check your blood pressure regularly.

Have your blood pressure checked each time you see a healthcare provider, including visits to a primary care doctor or Ob/Gyn. High blood pressure raises the risk of heart attack and stroke.

Know your cholesterol levels.

Before menopause, women tend to have high levels of HDL ("good") cholesterol, which can be protective against heart disease. After menopause, HDL levels go down. Women have an increased risk for heart disease and heart attacks after menopause. Everyone should have their cholesterol checked no later than 40 years of age. In some patients, it is appropriate to test cholesterol levels sooner.

When cholesterol levels are elevated, lifestyle changes such as regular exercise, improved diet and weight loss may be all that is needed. However, sometimes, your healthcare provider may recommend taking medication to reduce “bad” cholesterol, or LDL, levels. These recommendations are provided to reduce your risk of an adverse cardiovascular event, including a heart attack or stroke. Talk with your healthcare provider about your target cholesterol levels. 

Understand your risk factors for heart disease.

Preventing or controlling heart disease means making changes in the way that you live. A healthy heart requires a personal action plan.

A complete health checkup is a sensible first step. Your healthcare provider can help you develop a practical treatment plan. Even if you don't have risk factors for heart disease now, you can discuss ways to lessen your chances of developing them later.

Risk factors for cardiovascular disease that are specific to women include:

• Early menopause (less than 40 years of age).
• Being postmenopausal.
• High blood pressure or diabetes during pregnancy.
• Autoimmune disorders.

Risk factors for cardiovascular disease in both men and women include:

• Personal history of atherosclerosis, including coronary artery disease, ischemic stroke or peripheral arterial disease.
• Age over 55.
• Having a male relative (father or brother) under the age of 55 or female relative (mother or sister) under the age of 65 with coronary artery disease.
• High blood pressure.
• High levels of LDL cholesterol.  
• Type 1 or Type 2 diabetes.
• Chronic kidney disease.
• History of smoking or smoking/tobacco use.
• Not exercising, or minimal exercise.
• Obesity.

Take Action.

Understanding your risk factors is the first step in preventing heart disease. If you have concerns about your heart health, schedule an appointment with your healthcare provider for a preventive care visit today. Learn more about Overlake's award-winning Heart & Vascular program. For further information on heart disease risks and prevention, visit Heart Disease on CDC.gov.