Heart disease

Raise your awareness of heart disease and how you can lower your risk while boosting your health.

How common is heart disease in women?

Heart disease is widespread in women. More women die from heart attacks every year than men. Heart disease is the number one killer of women in the U.S.

Women’s heart attack symptoms

Research shows that women experience heart attack differently than men. Some women don’t feel chest pressure or pain when they have a heart attack. If you have these symptoms, call 9-1-1 right away:

  • Angina (dull, heavy or sharp pain in the center of the chest
  • Breaking out in a cold sweat
  • Chest discomfort or tightness
  • Dizziness, lightheadedness or fainting
  • Extreme fatigue
  • Feeling of impending doom
  • Nausea and vomiting
  • Pain in the back or upper abdomen
  • Pain in the jaw, throat or neck
  • Pain or discomfort in one or both arms
  • Shortness of breath

Lifestyle tips

There are actions you can take to reduce your risk of heart disease.

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  • Eat a heart-healthy diet high in fiber, rich in vitamins and minerals, and low in calories and saturated fat. The DASH (Dietary Approaches to Stop Hypertension) diet and the Mediterranean diet are both proven to reduce your risk of heart disease and heart attack. Whole-food, plant-based diets also significantly reduce the risk of heart disease and cardiovascular events like heart attack and stroke.
  • Limit alcohol. Moderate drinking (one drink a day for women) is considered safe. More than one drink a day may raise your blood pressure and blood lipids, increase the risk of cardiomyopathy (weakening of the heart muscle), spark arrhythmia (irregular heart rhythm) and cause weight gain.
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  • Move your body every day. Women who get about 30 minutes of moderate exercise a day tend to have lower blood pressure, cholesterol and weight than women who don’t. They also tend to live longer. Moderate exercise includes brisk walking, biking, raking leaves and gardening.
  • If you don’t have time to exercise every day, try to get 30 minutes of vigorous aerobic exercise three times a week. Vigorous activity includes running, jogging, swimming and cross-country skiing.
  • In addition to aerobic exercise, the American Heart Association (AHA) recommends moderate to high-intensity muscle-strengthening exercise at least two days a week.
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If you smoke, quit. This is one of the most important steps you can take to improve your overall health. Women who smoke are two to six times more likely to suffer a heart attack than women who don’t, and your risk increases with each additional cigarette smoked per day.

Weight management
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Maintain a healthy weight. Overweight women are more likely to develop heart-related problems than women at a healthy weight, even if they have no other risk factors. The AHA guidelines for women recommend a body mass index (BMI) between 18.5 and 24.9 and a waist circumference of less than 35 inches.

Stress management
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  • Reduce stress by getting enough sleep, saying no to additional responsibilities when you feel overwhelmed, and taking time for activities you enjoy.
  • During stressful moments, decrease your heart rate and blood pressure through deep breathing, guided imagery, mindfulness or taking a short break.
Annual checkups
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Make annual checkups a priority and follow your health care provider’s recommendations. All women over age 20 should have their blood cholesterol checked every four to six years, and their blood pressure checked every one to two years. If either reading falls outside the normal range, make appropriate lifestyle changes sooner rather than later.

Treatment options

Your cardiologist’s recommendations will depend on your personal health history and risk factors, the severity of your heart disease and the presence of other health conditions.

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  • Angiotensin II receptor blockers (ARBs) – Prevents blood pressure from climbing too high; includes candesartan, losartan and valsartan
  • Angiotensin receptor neprilysin inhibitors (ARNIs) – Helps keep arteries open to improve blood flow
  • Angiotensin-converting enzyme (ACE) inhibitors – Expand blood vessels and decrease ACE enzyme activity to allow blood to flow more freely, lowering blood pressure; common ACE inhibitors include lisinopril, ramipril, captopril and benazepril
  • Anticoagulants (blood thinners) – Decrease your blood’s ability to clot; common anticoagulants include warfarin and rivaroxaban · Antiplatelet medications – Prevent blood clots; drugs in this class include clopidogrel, ticagrelor, prasugrel, dipyridamole and aspirin
  • Beta blockers – Decrease your heart rate, lowering blood pressure and causing the heart to beat less forcefully; common beta blockers include propranolol and bisoprolol
  • Calcium channel blockers – Prevent calcium from entering the cells of the blood vessels and heart; includes amlodipine and nimodipine
  • Digitalis preparations – Make the heart pump with greater force; includes digoxin
  • Diuretics – Help your body eliminate excess fluids and sodium to lower your heart’s workload and reduce your blood pressure and swelling; common diuretics include hydrochlorothiazide, amiloride and furosemide
  • Dual antiplatelet therapy (DAPT) – Treats heart disease with aspirin and another antiplatelet at the same time
  • Low-dose aspirin – Help prevent heart attack in people who have already had a heart attack or cardiac procedure
  • Nitrates (vasodilators) – Relax blood vessels, increase blood supply to the heart and reduce the heart’s workload; available as chewable tablets, capsules and creams
  • Nonstatin drugs – Reduce blood cholesterol; may be an option if statins don’t work for you
  • Statins – Reduce blood cholesterol by interrupting the production of cholesterol in your liver; common statins include atorvastatin, rosuvastatin and simvastatin
Surgery and procedures
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  • Angioplasty – Uses a thin, flexible tube (catheter) with a laser tip or a tiny balloon on the end to open a blocked blood vessel; sometimes doctors also place a mesh tube called a stent to keep the blood vessel open.
  • Atherectomy – Removes plaque from a blocked artery.
  • Radiofrequency ablation – Guides a catheter with an electrode on the tip to place where an abnormal heart rhythm originates; the electrode uses radiofrequency energy to destroy cells in that area to eliminate the arrhythmia.
  • Heart valve replacement – Takes out an unhealthy heart valve and puts in a healthy one.
  • Bypass surgery or coronary artery bypass graft (CABG) – Improves blood flow to your heart and reduces heart attack risk by taking blood vessels from another part of the body and using them to redirect blood flow around a blocked artery; may be performed using traditional (open) or minimally invasive techniques.
Cardiac rehabilitation
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If you have a heart attack or a heart procedure, your doctor will probably recommend cardiac rehabilitation to help you recover, improve your overall health, and prevent future heart attacks.

Frequently asked questions

What are the risk factors for heart disease?
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The primary risk factors for heart disease in women are:

  • Age (perimenopausal and postmenopausal women are at increased risk due to the loss of estrogen)
  • Diabetes or prediabetes
  • Excess weight or obesity
  • Family history of heart disease
  • High blood pressure
  • High cholesterol
  • High c-reactive protein (CRP)
  • High triglycerides
  • History of preeclampsia
  • Sedentary lifestyle
  • Smoking
  • Systemic autoimmune diseases (such as lupus and rheumatoid arthritis)
No one in my family has had heart disease. Does that mean I don’t need to worry about it?
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Family history plays a much smaller role than other risk factors. The presence of other risk factors can outweigh the influence of good genes.

Do birth control pills increase heart disease risk?
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Oral contraceptives used to have much more estrogen than they do today—those high-dose pills increased risk of heart and vascular disease, especially among women who smoked.

Today’s pills contain lower doses of estrogen, and though they still may increase a woman’s blood pressure, they generally don’t increase her risk of heart or vascular disease. The exception is for women who smoke—even with the low-dose pill, smoking boosts a woman’s risk of cardiovascular problems, particularly if she is over 35.

Why does a woman’s risk of heart disease go up after menopause?
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Estrogen helps keep the lining of the blood vessels thin and pliable. It may also help keep arteries free from plaque. When estrogen levels drop during menopause, these protective effects fade as well, and the risk of heart disease increases.

Should I exercise if I’ve been diagnosed with heart disease?
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Yes. Exercise will help strengthen your heart muscle, lower your blood pressure, decrease cholesterol and keep your blood sugar in check. It also may help you manage your weight, reducing your risk of complications from heart disease. Talk to your doctor before beginning a new exercise program; follow his or her guidelines and recommendations.

Contact us

Talk to a care navigator or schedule an appointment at the Women’s Health & Wellness Center.