Heart disease has become the leading cause of death for women in the United States, responsible for about 1 in 4 deaths among women.
Starting in the late 1980s, coronary artery disease - defined as a blockage of the arteries that supply blood and oxygen to the heart - has killed more women each year than men. Mortality rates from CAD are on the rise in women aged 35 - 54 years. And worryingly, nearly two-thirds of women who die from heart disease had no previous symptoms
Why are women at higher risk for heart disease than men?
There are several reasons, says Kavitha Chinnaiyan, M.D., Beaumont cardiologist.
A Lack of Recognition by Doctors
“CAD classically was considered a man’s disease,” Dr. Chinnaiyan says. “It’s taken more than a decade for doctors to realize that more women are actually affected. Women are protected somewhat until menopause or so, but that’s not always the case.”
In fact, more women are being diagnosed in their late 30s and early 40s.
Atypical Symptoms
With men, heart disease typically manifests itself through the classic symptoms: crushing chest pain or tightness. Women, on the other hand, often present symptoms like shortness of breath or pain in the neck, jaw, throat, upper abdomen or back.
“Women tend to have a lot more vague symptoms - just being tired, not being able to say what’s wrong with them. That’s all from the heart not being able to get enough oxygen,” Chinnaiyan says.
Biological Differences
Women have smaller arteries than men, so coronary artery disease develops differently, and more diffusely. Also, CAD in women tends to afflict smaller arteries that feed the heart. An angiogram, a procedure commonly performed to look for blockages in the coronary arteries, won’t always catch signs of CAD for these reasons.
Delays in Getting Care
The last reason has to do with deeply engrained societal norms.
“Women by nature are conditioned socially and culturally to be nurturers,” Dr. Chinnaiyan explains. “We generally put ourselves last.
“A woman is more likely to take her husband, having the same symptoms, to the doctor, rather than taking herself.”
Why Risk Assessment is So Important
It’s important for women to know the main risk factors for heart disease: high blood pressure or cholesterol, diabetes, smoking, lack of exercise, poor diet and high stress.
Dr. Chinnaiyan says it’s a good idea to start knowing your blood pressure, cholesterol and blood sugar numbers staring in your late 20s or early 30s. Getting regular exercise (at least 30 minutes a day of moderate activity), avoiding inflammatory foods such as refined sugars and processed foods, limiting animal products and managing stress become increasingly important with age.
“Look into what is leading to stress in your life,” says Chinnaiyan, who teaches meditation and prescribes it to patients as a way to relieve stress. “You have to be able to work on it from early on in your childhood. It’s really hard to change in your 70s if you haven’t worked on it earlier in life.”