Women and Heart Disease: Frequently Asked Questions

Two hands holding a heartHeart disease is the number one cause of death for both women and men in the United States. In fact, heart disease is the cause of 1/3 of all deaths in women—that’s more than the deaths caused by all cancers combined.

The good news is, about 80 percent of cardiac and stroke events may be prevented with proper education and action. The following are frequently asked questions related to women and heart disease. If you have any questions about your heart disease risk, be sure to talk with your doctor.

Are women at a higher risk for heart disease than men?
For years, both the medical community and the public viewed heart disease as a man’s disease. This has been proven false; in fact, any person with the right risk factors and the right family history has the potential to develop heart disease. About the same number of women and men die of heart disease each year, however, fewer women than men survive their first heart attack, and women have a higher risk of stroke than men.
Do men and women experience the same symptoms associated with heart disease?
Heart attack symptoms can be different for men and women. While both men and women can experience the most common symptom of a heart attack, which is chest pain, 20 percent of the time women don’t experience chest pain at all during a heart attack. More often, women experience less recognizable symptoms like shortness of breath, dizziness, nausea, lightheadedness, fainting, or pain/discomfort in the upper back, arms, neck, jaw, or stomach.
Is it true that women are less likely to call 9-1-1 when they are experiencing symptoms associated with a heart attack?
In many cases, women don’t realize they are experiencing a heart attack. The symptoms women experience when they have a heart attack aren’t always clear or well understood, which make many women hesitant to dial 9-1-1. If you experience any symptoms (not just chest pain) related to a heart attack, it’s important that you call 9-1-1 if your symptoms don’t subside.
If I am young and physically fit, do I have to worry about heart disease?
Heart disease affects women of all ages. While it’s true that as you get older your heart disease risk increases, for younger women the combination of smoking and taking birth control pills increases the risk of heart disease by 20 percent.

Overeating and a sedentary lifestyle can also increase the risk for heart disease, but they are not the only things that do. Even if you are fit, if you have a family history of heart disease or other cardiovascular risk factors such as high cholesterol, diabetes or smoking, you are at an increased risk for heart disease.
What can I do to reduce my risk of developing heart disease?
There are both non-modifiable (things you can’t change) and modifiable risks (things you can change) associated with heart disease.

Some non-modifiable risks include your age and family history, which are two factors that contribute to your risk of heart disease.

Some modifiable risks include smoking, eating healthy, keeping a healthy weight or losing weight, staying active with regular exercise, and taking steps to keep your cholesterol, blood sugar, and blood pressure under control. These factors contribute to your risk of developing heart disease; however, you have the ability to control or manage these factors.
Are there any female-specific disorders that increase a woman’s risk of developing heart disease?
There are several female-specific disorders that increase a woman’s risk of heart disease, one of these being polycystic ovarian syndrome (PCOS). Women with PCOS may have enlarged ovaries with small cysts on the outer edges. Insulin resistance, metabolic syndrome, and obesity are the factors related to PCOS that increase a woman’s risk of heart disease.

Turner syndrome is a genetic condition that only affects females. 5-10 percent of children with Turner syndrome have a severe constriction of the major heart vessel, increasing the risk of heart disease. Many women with Turner syndrome also have high blood pressure—a major risk factor for heart disease.

There are also conditions related to pregnancy that could increase a woman’s risk of developing heart disease, called cardiomyopathy. Premature birth, low-birth weight, and pregnancy-induced hypertension (high blood pressure) are some of these risk factors.

Menopause often brings with it an increase in cholesterol levels, hypertension and weight gain, which are all risk factors for heart disease.
What are some questions I should ask my doctor about my heart’s condition, and my risk of developing heart disease?
  1. How does my family history affect my heart health?
  2. Is my blood pressure reading normal?
  3. What is my cholesterol level and how does this affect my heart?
  4. Am I experiencing heart-related symptoms because of my age, gender, or weight?
  5. Are my symptoms indicating a heart attack?
  6. Are my exercise habits causing my heart symptoms?
  7. Is my level of stress/anxiety increasing my risk of heart complications?
  8. What are my treatment options for the heart symptoms I’m having?
  9. What should I do if my symptoms persist?
  10. Are there programs to help me quick smoking?
  11. Are my blood sugars normal?
  12. How can I begin an exercise program?

For more information or to schedule an appointment with a University of Iowa Heart and Vascular Center physician, call us at 319-356-7102.

Linda Lee, MD
UI Heart and Vascular Center
Division of Cardiovascular Medicine
University of Iowa Hospitals and Clinics