Women’s Heart Health
If you were asked what the number one killer of women in the U.S. is and you answer heart disease, you’d be among the 56% of women who got that right. That awareness has been on the decline over the last decade according to a study from the American Heart Association with younger women contributing more to that decline than older groups.
Heart Health is Whole Body Health
Health risks during pregnancy such as elevated blood pressure and gestational diabetes increase the risks of later developing cardiovascular disease.
That is only one example of the intersection between reproductive health and cardiovascular health for women
Women with endometriosis have a 52% greater risk for heart attack and are more than a third more likely to need heart surgery.
Polycystic ovary syndrome (PCOS) is linked to both an increased risk of developing cardiovascular disease and pregnancy patients with PCOS are more likely to experience heart-related issues during delivery.
For women who have high blood pressure during pregnancy, their risks for cardiovascular disease are higher as early as 10 years after pregnancy. When you consider that 20% of pregnant women experience a high blood pressure disorder, the impact is significant.
During perimenopause changes in hormone levels impact factors contributing to cardiovascular disease. For examples, the production of LDL (“bad cholesterol”) and HDL (the “good” kind) change.
It isn’t enough to know the risk that cardiovascular disease presents to women. Understanding unique challenges in diagnosis and treatment for women will empower you more in your heart health and enable you to advocate for yourself (or a loved one).
It’s not the classic chest clutching pain that is a concern
The symptoms can differ between women and men, especially when having a heart attack. We all have an image in our heads of someone clutching their chest in pain. However, women are more likely than men to have symptoms they don’t realize are indicative of a heart attack including:
Pressure and tightness rather than pain
Discomfort in the jaw, neck or upper back
Vomiting
Sweating
Fatigue
Multiple factors impact getting the appropriate medical attention for cardiovascular health.
Doctors and medical professionals are not recognizing these as signs any more than women are themselves. Younger women reporting these symptoms may be told they are suffering from anxiety or lack of sleep.
Add that to the fact that women, and particularly women of color, wait longer in emergency rooms and are more likely to be turned away with these symptoms without further investigation.
Even when the threat is clear, women are less likely to receive CPR from bystanders while medical professionals are called.
Different Kinds of Heart Attacks
Women are also more likely to experience “unusual heart attacks”. MINOCA are heart attacks not caused by blocked arteries. It stands for myocardial infarction with non-obstructive coronary arteries.
Research indicates women are 5 times more likely than men to have MINOCA.
There are different types of MINOCA heart attacks. While they make up a smaller percentage of all heart attacks (between 5% and 10%), 40% to 60% of MINOCA patients are women.
There are several types of MINOCA
SCAD or spontaneous coronary artery dissection which can occur in otherwise healthy women in their 40s and 50s more frequently than it does in men. There may be a hormonal connection as they occur more often in women during pregnancy or in women on hormone replacement.
While you can’t die of a broken heart, stress cardiomyopathy refers to cardiac damage is caused by intense stress - physical or emotional - that weakens the heart
There are very small blood vessels in the heart that can become too narrow or spasm. Known as microvascular disease, in severe cases, it can cause a heart attack.
Our hearts are muscles and when there are muscle or structural issues in the heart, it can cause this type of heart attack.
As with any muscle, the heart can experience spasms. In the case of coronary artery vasospasm, it obstructs the flow of blood in the heart.
What you can do
To learn more about heart health for women, check out these resources
American Heart Association’s campaign Go Red for Women
EveryDay Health Heart Disease is still missed in women - and young women fare worst
Johns Hopkins Menopause and the Cardiovascular System
Columbia What Black Women Should Know about Heart Disease
Providence What Every Woman Should Know about MINOCA Heart Attacks