Women & Heart Disease: What You Need to Know

02/19/2020 | 8 min. read

Dr. Stephen Sinatra

Dr. Stephen Sinatra

Women and Heart Disease

Did you know heart disease is the number one killer of women? Women’s heart disease statistics show that heart disease kills five times more women than breast cancer. Plus, women are twice as likely as men to die within the first few weeks after a heart attack.

Why are women so vulnerable to heart disease? The reason is that women’s hearts—physiologically speaking—are smaller than men’s hearts, and their arteries are narrower—making them more prone to plaque buildup. Plus, as women reach the age of 45 they begin to lose their natural hormonal protection against heart disease, estrogen.

Yet, despite these clear facts on women and heart disease, many doctors still treat heart disease as a man’s disease. I can’t tell you how many women with heart disease are incorrectly diagnosed until they end up in the emergency room. And even in the emergency room, doctors often dismiss the subtler symptoms of heart disease in women as anxiety, indigestion, or fatigue—when in fact the real issue is the heart.

Symptoms of Heart Disease in Women

While men tend to get the “classic” symptoms of heart disease that we’re all familiar with, such as chest pain and shortness of breath, women’s heart disease symptoms can be much subtler.

Women’s heart disease symptoms can include:

  • Shortness of breath
  • Back or chest pressure
  • Tightening of the throat
  • Tingling or pain in your jaw, arm, or elbow
  • Lightheadedness with exercise
  • Dizziness
  • Nausea or indigestion
  • Profuse sweating
  • Sudden profound fatigue

For some, the symptoms of heart disease in women are so mild that they can be mistaken for the flu. So, if you have one or more of these symptoms, don’t dismiss them—and don’t let your doctor minimize them either.

8 Signs You Could Have a Heart Attack Next Month

Many people don’t know this, but heart attack symptoms in women can surface a month before a heart attack occurs—giving you time to ward off a cardiac event before it happens. These early heart attack symptoms in women can include:

  1. Pronounced fatigue 
  2. Sleep disturbances 
  3. Shortness of breath
  4. Indigestion
  5. Loss of appetite
  6. Difficulties thinking/remembering
  7. Anxiety
  8. Weak/heavy arms

It’s important to note that these heart attack symptoms in women can come and go, disappearing as mysteriously as they came on. So, if you have intermittent symptoms you should consider getting a full cardiovascular workup. This is not something you want to ignore.

Risk Factors for Heart Disease in Women

While women and men share many of the same risk factors for heart disease, there are also many importance differences. Knowing these differences can help you to protect yourself against having a cardiac event.

  • High Blood Pressure: Women and high blood pressure tend to go together. The reason is that women have smaller blood vessels. Plus, women are more likely than men to have diastolic dysfunction, making the deadly side effects of high blood pressure in women a much greater health risk.

  • Menopause: While men tend to have cardiovascular events about 10 years earlier than women, a woman’s risk is equal to (or greater than) a man’s once she reaches menopause. The reason is that during menopause, estrogen levels drop—and estrogen is what keeps your arteries flexible and strengthens your arterial walls. When your estrogen declines, your blood pressure is likely to rise. Plus, estrogen is associated with the production of “good” HDL cholesterol that protects against heart disease in women—therefore, as estrogen declines, so can HDL cholesterol.

  • Being 20% (Or More) Over Your Ideal Weight: Weight is a significant risk factor for heart disease in women and men, and losing even a few pounds can improve your heart health. That’s because shedding unwanted pounds helps to reduce your inflammation levels, lowers your blood pressure, reduces your risk of developing type 2 diabetes, and decreases your risk of having a heart attack or stroke.

  • Having a Waist Size of 36 Inches or More: Your waist size is important since it’s an indicator of how much belly fat you have. Unlike other forms of fat, belly fat is metabolically active—secreting chemicals that cause inflammation throughout your body. If you don’t get that inflammation under control, it can damage the blood vessels in your kidneys and damage your coronary arteries. For women, to prevent heart disease you want to keep your waist size at less than 36 inches.

  • High Triglycerides: While triglycerides are a risk factor for heart disease in both men and women, a high triglyceride level (above 200 mg/dL) is more problematic for women than men. If you’re a woman with diabetes and high triglycerides, you have an up to 200 times greater risk of developing heart disease.

  • Leading a Sedentary Lifestyle: Inactivity can raise your risk of developing high blood pressure and diabetes, both of which can contribute to heart disease in women. Since women and high blood pressure are so closely related, staying active is very important.

  • Diabetes: Heart disease and diabetes are closely related for both men and women, but women with diabetes are twice as likely to develop heart disease as men. Plus, women who have type 2 diabetes are more likely to have a heart attack at a younger age than men and have a greater likelihood of dying after a first heart attack than men.
     
  • Smoking: While smoking is hazardous to everyone’s health, it’s even more dangerous for women than it is for men. Women who smoke have a 25% higher risk of developing coronary artery disease than men. Even smoking just one cigarette a day can significantly raise your heart disease risk. So, if you smoke, you want to take steps to quit

  • Stress: Research has shown that mental stress can affect women’s hearts very differently than it does men’s hearts. Women who have experienced mental stress are more likely than men to have myocardial ischemia (reduced blood flow to the heart). They are also more likely to have blood platelet aggregation (early blood clots).

How Women Can Prevent Heart Disease

The good news about women and heart disease is that there are many things you can do to prevent it. Taking these simple steps can help you to ward off heart disease, as well as prevent high blood sugar and diabetes.

Take Heart Health Supplements: To prevent heart disease in women, I recommend a good probiotic and multinutrient formula—one that’s rich in antioxidants and B vitamins. I also recommend taking the following heart health supplements in divided doses: 

  • Broad-spectrum magnesium (400 to 800 mg)
  • CoQ10 in hydrosoluble form (50 to 100 mg for prevention, and up to 300 mg if you have a heart condition)
  • D-ribose (5 g for general energy support, 10 to 15 g if you have heart failure, cardiovascular disease, peripheral artery disease, or stable angina)
  • Omega-3 fatty acids (1 to 2 g for prevention and 2 to 3 g if you have heart disease)

Keep Your Blood Pressure in Check: Since women and high blood pressure tend to go together, you want to check your blood pressure regularly. For both women and men, a healthy blood pressure level is less than 120 mmHg/80 mmHg. If you’re one of the many women with high blood pressure, you want to take steps to proactively lower it, including modifying your diet, taking blood pressure-supporting nutritional supplements, exercising, and reducing stress.

Use Over-the-Counter Painkillers with Caution: Research has shown that daily use of over-the-counter pain relievers such as Advil and Motrin (ibuprofen) and Tylenol (acetaminophen) can contribute to high blood pressure in women. Just 500 mg of acetaminophen per day can put women at a 93% to 99% greater risk of developing high blood pressure within 3 years compared to women taking less than 500 mg.

Get Moving: Getting regular moderate exercise is one of the best ways to ward off heart disease, and one of the most powerful exercises you can do for your heart is walking. Research has shown that women who walk briskly for 3 hours per week can cut their risk of a heart attack by 40%. Walking 5 hours per week can cut the risk of a heart attack in half!

Eat a Heart Healthy Diet: To keep your heart healthy, you want to eat a heart healthy diet. This means limiting (or better yet eliminating) simple carbohydrates, sugars, and trans fats from your diet. Instead, I recommend eating a Pan Asian Modified Mediterranean diet that’s filled with heart healthy omega-3s, fresh organically grown fruits and vegetables, olive oil, and other heart healthy foods.

Reduce Stress: Stress can wreak havoc on your heart and entire body, so it’s important to take steps to mitigate it by minimizing the number of stress triggers in your life. You can also help to defuse stress with exercise, yoga, T’ai Chi, meditation, and grounding.

If You Smoke, Quit: Women, heart disease, and smoking are closely related. Quitting can help your blood pressure and heart rate within just 20 minutes. After a month of not smoking, your blood flow will begin to improve. Then, 12 months later your heart disease risk will drop by half—and 5 years later your risk will be equal to a nonsmoker.

What to Do If You Think You Are Having a Heart Attack

For women with heart disease, it’s important to know what to do if you think you might be having a heart attack.

  • Chew an aspirin as soon as your heart attack symptoms begin. Aspirin can help to break down possible blood clots. Also, take nitroglycerin if it has been prescribed for you.

  • Call 911. Don’t drive yourself to the hospital or count on a friend or family member to drive you. When you call 911, cardiac care begins as soon as the emergency medical technicians arrive—and continues in the ambulance on the way to the hospital.

  • Once at the hospital, don’t let the doctors and nurses dismiss your symptoms. You don’t want to waste valuable time by having them dismiss your symptoms of heart disease as stress, anxiety, or indigestion. You want to be very clear about your symptoms and insist on getting a full cardiac workup.

Dr. Stephen Sinatra

Meet Dr. Stephen Sinatra

Dr. Stephen Sinatra is a highly respected and sought-after cardiologist and nutritionist with more than 30 years of clinical practice, research, and study. His integrative approach to heart health focuses on reducing inflammation in the body and maximizing the heart's ability to produce and use energy.

More About Dr. Stephen Sinatra