Women and Heart Health: Why Gender Matters


Heart disease remains the number one cause of death in the United States, making it a major public health concern. The term “heart disease” encompasses multiple different diseases of the heart and blood vessel system. The most common of these diseases, heart attacks and strokes, are caused by a blockage of blood vessels in the heart or brain. Although heart disease impacts both genders fairly equally, with one in four people being affected by heart disease, women tend to experience symptoms of this condition in a slightly different way.1

Heart Disease and Women

Many women think that heart disease mostly impacts men, but both genders are at equal risk. Women tend to have smaller hearts which physiologically changes how heart attacks happen. For women, a heart attack can be caused by an erosion of the smaller blood vessel by plaque or by small vessel disease, where blockages occur in the small vessels of the heart. Men on the other hand are more likely to have blockages of the larger vessels.

Women also tend to be slightly older when they have their first heart attack, with the average age being 70 years old compared to 66 for men. One reason is that estrogen has a protective effect on the heart prior to menopause.2

Although women are more likely to have smaller heart attacks that are not fatal, they are frequently more impacted and disabled by them. This may be because they tend to happen when women are slightly older and may have more risk factors.

Stroke risk differs between men and women, as women are slightly more likely to have a stroke. This difference might be related to the fact that women live longer than men and older age is again a risk factor.3

    Difference in Heart Attack Symptoms for Women

    There are many misconceptions about heart attack symptoms in women. Some people believe symptoms are completely different for women, but one commonality between men and women is that they both tend to experience the same chest pain and tightness. Women are more likely to have heart attacks without any symptoms, which may be where the misconception about symptoms comes from.

    Other symptoms that seem to be female-specific include:4

    • Extreme fatigue 3-4 weeks before a heart attack
    • Shortness of breath or sweating without exertion or when lying down
    • Pain in the neck, back, arm, or jaw

    Difference in Stroke Symptoms for Women

    Women also experience slightly different symptoms when they are having a stroke. A few of these symptoms for women include:5

    • Fainting or loss of consciousness
    • Weakness
    • Shortness of breath
    • Change in behavior
    • Confusion, hallucination, unresponsiveness
    • Pain
    • Agitation
    • Seizures

    Early heart attack treatment is critical for preventing long-term complications. However, women tend to delay treatment because many of these symptoms can go unnoticed.

      Risk Factors for Women

      Women have slightly different risk factors for heart disease and stroke than men do. Hormones and pregnancy can increase risk for heart disease. For example, women with pre-eclampsia, or high blood pressure during pregnancy, are at greater risk for heart disease.

      Other risk factors for heart disease and stroke include:3

      • Birth control pills, which tend to raise blood pressure
      • Migraine headaches with aura
      • Anxiety and emotional stress
      • Endometriosis
      • Polycystic ovarian disease
      • Hormone replacement therapy


      Lifestyle can have a major impact on reducing risk of heart disease and stroke. Diet, physical activity, not smoking, and stress management can all lower the risk. The Mediterranean diet, a diet that focuses on fruits, vegetables, healthy fats, and fish was found to reduce risk of heart disease in women by 25%.6

      There are also many medical conditions that can increase risk of heart attack, these include diabetes, high blood pressure, and obesity. These risk factors should be medically managed in order to lower risk.

      Women need to be informed about their risks and preventive measures of heart disease to help them stay healthy throughout life. Ready to take your heart health into your own hands? Talk to your doctor about your risks and stay tuned to our blog for more heart healthy tips!



      1. Centers for Disease Control and Prevention; Women and Heart Disease Fact Sheet. Accessed January 21, 2019.
      2. Cleveland Clinic. Women or Men- Who Has a Higher Risk of Heart Attack? Published February 17, 2017, Accessed January, 21, 2019.
      3. National Stroke Association. Women and Stroke. Accessed January 21, 2019.
      4. American Heart Association. Heart Attack Symptoms in Women. Accessed January 21, 2019.
      5. American Heart Association. Risk Factors. Accessed January 21, 2019.
      6. JAMA Netw Open.2018;1(8):e185708.


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      • Blog Contributor
      Comments 1
      • Wendy dougherty
        Wendy dougherty

        Your article was very interesting but you didn’t mention genetics. I was 71 feeling very tired and short of breath. My Dr. sent me to a cardiologist. He didn’t seem worried, EKG was fine but to make sure he sent me for a stress test, abnormal. Finally turned out that I had two arteries 100% blocked and the widow maker was 80% blocked. My cardiologist said you ladies and your symptoms. A few weeks later I had a triple by pass. Just over a year later I again felt ill and exhausted. Turns out 2 of the grafts had failed. The widow maker was my lifeline. So I am on various medicines and take it one day at a time. Everybody was amazed that I had heart problems. I am not fat, I am very active in my garden, walk my dog, quit smoking many years ago.
        However on my maternal side there were heart problems. My mother was skipped over, she lived till 91, however it got me and nobody was more surprised than me. I do take Quinol and I
        am sure it is helping me. So genetics play a big part in this disease. Hope you find this story interesting.

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