Women and Heart Disease


When it comes to heart disease, men and women are not created equal. In whatever way you look at heart disease—the way it is best diagnosed, the symptoms, the risk factors that contribute to its progression, as well as treatments or their application—clear differences emerge based on whether you are a woman or a man. While efforts are underway to better understand sex differences in heart disease, today’s research is just a start.

So, if you are a woman or care for one, listen up. Arming yourself with knowledge about your risk is important. Coronary heart disease is not just a “man’s disease,” and its effect on women tends to be riddled with misunderstandings. While deaths related to coronary artery disease—known as CAD for short—are declining overall, rates are increasing in young women. To put it into context, more women have died from heart disease than all cancers combined. All told, heart disease claims the lives of 1 out of 3 women in the U.S. each year. Yet, half of American women are still unaware that heart disease is their No. 1 killer.

So what is CAD, and how can you protect yourself and the women in your life? Read on, and share these tips.

What is Coronary Artery Disease?

Coronary artery disease is the most common type of heart disease. It develops when your coronary arteries, which act like fuel lines to supply blood and oxygen to the heart, become damaged or diseased. This often results when a waxy substance called plaque or atherosclerosis builds up in the walls of the arteries.  

When your coronary arteries become narrowed or blocked, it means there is less blood flow to the heart; in some cases, plaque can rupture and blood flow is abruptly and completely blocked. CAD can lead to:  

In women more often than men, these things can occur even without evidence of any obstructive coronary artery disease, which makes the diagnosis and treatment in women challenging.

Women are just as likely as men to develop CAD. In women, CAD usually develops seven to 10 years later in life compared with men. Menopause seems to kick off a host of risk factors including:

  • Weight gain, especially carrying excess fat around your waist or midsection
  • Diabetes, which is the strongest risk factor in women; in fact, studies suggest diabetes more than triples  the risk of CAD in women, compared with doubling the risk for men
  • High blood pressure
  • Change in cholesterol profile (rise in LDL and triglycerides, fall in HDL)  

Women tend to:
  • Have different and more subtle symptoms
  • Have no overt signs of blockages in the three major coronary arteries on tests, although blood flow to the heart muscle is reduced
  • Have blockages or dysfunction in smaller arteries (men are more likely to have plaque buildup in the large arteries around the heart)
  • Be treated less aggressively than men
  • Be less likely to dial 911
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Published: February 2017
Editorial Team Lead: Gina Lundberg, MD, FACC
Medical Reviewer: Martha Gulati, MD, MS, FACC

Featured Video

Women often experience heart attack symptoms differently than men. It's important for a woman to be able to recognize the symptoms of a heart attack and react quickly by calling 911.

Infographic: Coronary Artery Disease (CAD)

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