Heart health for women

This content is sponsored by Johns Hopkins Medicine.

Heart disease symptoms can present different for women. Recent studies suggest that heart attack rates are rising among women between the ages of 35 and 54. Learn the risk factors and signs of heart disease and what you can do to help prevent heart attacks.

Heart Attack Risk Factors for Women

Several factors increase the chance of developing heart disease. Almost 50% of all Americans have at least one of three major risk factors for the condition:

  • High blood pressure: Women can develop high blood pressure as a side effect of birth control pills or during pregnancy. All women over 65 are more likely than men are to have high blood pressure.
  • High cholesterol: Estrogen seems to protect women against unhealthy levels of cholesterol. But after menopause, estrogen levels drop and high cholesterol becomes more likely.
  • Smoking: Although men are slightly more likely to smoke, the gap in cigarette usage between genders is smaller than ever and women are less likely to be able to quit successfully.

Additional risk factors include:

  • Diabetes
  • Obesity
  • Family history of heart disease
  • Age (risk increases as you get older)
  • Unhealthy diet
  • Physical inactivity
  • Excessive alcohol use

Do hormones affect your risk of a heart attack?

Many women use prescription hormone drugs for birth control or for reducing symptoms of menopause (called hormone replacement therapy). Could these drugs jeopardize your heart health?

“Birth control pills can increase your risk of having a blood clot, either in the heart or in the legs, and they can also raise your blood pressure. So, if you have a history of high blood pressure or clotting problems, other types of contraception might be a better fit for you,” says Colliver. “But for most young women, it’s safe to take birth control medication.”

Colliver notes that women over the age of 50 are at an increased risk for heart disease and should completely avoid estrogen and progesterone drugs, if possible. “If your overall risk of heart attack is extremely low and you desperately need relief from hot flashes and other postmenopausal symptoms, then hormone replacement therapy may be fine for you,” says Colliver. “But after the age of 65, we really try to avoid using them at all because they do increase the risk of heart disease and potentially breast cancer.”

Heart Attack Symptoms in Women

Although many people think heart attacks happen mostly to men, heart disease is the leading cause of death for both men and women. So it’s just as important for women of every age to recognize heart attack signs and seek immediate medical attention.

For the vast majority of people — men and women — chest pain or discomfort is the primary symptom of a heart attack. However, women are more likely than men are to have less recognizable heart attack symptoms, such as:

  • Pain or discomfort in different parts of the upper body (back, neck, jaw, arms or stomach)
  • Shortness of breath
  • Lightheadedness
  • Cold sweats
  • Fatigue
  • Nausea and vomiting

What You Can Do Now to Prevent an Early Heart Attack

Although some risk factors are beyond your control, there are many things you can do to protect your heart health. It’s estimated that 80% of heart disease, including heart attacks and strokes, can be prevented through lifestyle changes, such as:

Virginia Colliver, M.D. is an expert in general and preventive cardiology, heart disease in women, echocardiography and nuclear cardiology.  Dr. Colliver is a cardiologist with Johns Hopkins Community Physicians-Heart Care (JHCP) in Bethesda, Maryland and is affiliated with Suburban Hospital and Sibley Memorial Hospital.


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