Heart disease is the number one killer of women, surpassing all cancers combined. Yet, awareness lags, and medical research has historically shortchanged women. Here are seven critical facts every woman needs to know.
Women face unique risk factors beyond the standard list: high blood pressure, cholesterol, diabetes, and smoking. Pregnancy complications like preeclampsia or gestational diabetes, polycystic ovary syndrome (PCOS), autoimmune diseases (lupus, rheumatoid arthritis), and early menopause (before age 45) all elevate risk.
Menopause is a critical transition. As estrogen declines, blood pressure and cholesterol rise, and arteries stiffen. Many women are surprised when their numbers worsen despite maintaining healthy habits.
Heart attack symptoms in women can differ from the classic crushing chest pain. While chest pressure is common, women often experience shortness of breath, nausea, dizziness, jaw or upper back pain, cold sweat, and extreme fatigue. They may also downplay symptoms due to family obligations or fear of being dismissed by doctors.
Women can have heart attacks even without major artery blockages. Conditions like coronary microvascular disease (affecting small vessels), coronary artery spasms, and spontaneous coronary artery dissection (a tear in the artery wall, especially postpartum) are more common in women. Takotsubo cardiomyopathy (broken-heart syndrome) is triggered by severe stress, primarily in postmenopausal women.
Standard tests may miss these atypical heart attacks. A normal angiogram does not rule out microvascular or spasm-related issues. Follow-up with a cardiologist for specialized tests like PET scans, heart MRIs, or coronary function testing is crucial.
Medical research has long excluded women. Treatment guidelines are based on studies with few female participants, and even stents are often optimized for male anatomy. Doctors may also delay prescribing necessary blood pressure and cholesterol medications to women of reproductive age, due to pregnancy concerns.
Women need to advocate for themselves. If symptoms feel wrong, push for a thorough evaluation. The medical system must become more accommodating, but knowledge is a powerful first step.