Heart disease is a condition that affects the way your heart functions. It is a group of conditions that occur from different root causes. You're not alone if you have risk factors for heart disease or a history of heart problems. About eighteen million adults in the U.S. live with coronary artery disease. But most people think of heart disease as one condition.1 Understanding the symptoms and risk factors of heart disease in women as well as the treatment and ways to prevent them can help protect you from these conditions.
Understanding heart disease in women
For many years heart disease has been known as “Men’s Disease” and a lot of healthcare professionals and doctors still believe that women are less likely to have a heart disease or heart disease risk factor than men.2 This has made the condition to be underdiagnosed and undertreated in women.
According to a report published in the American Heart Association Journal in January 2020, heart disease is a leading cause of death in the United States and around the world and the number one cause of death in women3 But little is known about how the risk of heart disease affects adolescent and young adult women.4
Heart disease comprises several types of heart conditions. And each condition has its symptoms and treatment. Common heart conditions are:5
- Coronary artery disease
- Heart failure (for example heart attack, and high blood pressure)
- Structural heart disease
- Other (for example infections, enlarged heart muscles, and inherited disorders)
Coronary artery disease (CAD):
CAD is a type of heart disease where the arteries of the heart cannot deliver enough oxygen-rich blood required for the heart to function. CAD is often caused by fat that builds up inside the linings of the coronary arteries forming a plague. This buildup can cause a partial or total blockage of blood flow in the large arteries of the heart.
Arrhythmias occur when your heart has an irregular beating pattern. Arrhythmias happen on their own or may start from other heart problems.
Heart failure can happen when your heart doesn't pump enough blood to meet your body's needs. It is usually caused by coronary artery disease, but it can also happen when you have other disease conditions such as thyroid disease, high blood pressure, heart muscle disease, or certain other conditions.
Structural Heart Disease:
The heart is made up of four valves. These valves are open and close to direct blood flow between the heart's four chambers, the lungs, and blood vessels. When there is an abnormality, it becomes hard for a valve to open and close the right way it should, this can cause blood flow to be blocked or blood can leak.
Heart Muscle Disease:
Heart muscle disease happens when the heart may get too weak to pump well. The heart gets stretched, thickened, or stiff. Some common causes include genetic heart conditions, reactions to some drugs or toxins (such as alcohol), Chemotherapy, and infections from a virus.
Symptoms of heart disease in women
Some women experience no symptoms, while others may have:1
- Have pain in the jaw, throat, or neck
- Have pain in the upper abdomen or back
Angina is chest pain or discomfort that occurs if a part of your heart does not get enough oxygen-rich blood to function. It is the most common symptom for women and men. You may feel chest pain that is like.
- Heaviness or pressure
- Tightness in the chest
- Burning sensation
Other symptoms include extreme tiredness
- Feeling sick in the stomach
Sometimes heart disease may not show signs and not be diagnosed until you have other symptoms or emergencies, for example
- Heart attack: Some symptoms you may experience include; Chest pain or discomfort, upper back or neck pain, indigestion, heartburn, nausea or vomiting, extreme fatigue, upper body discomfort, dizziness, and shortness of breath
- Arrhythmia: you could experience fluttering feelings in the chest
- Heart failure: Examples of symptoms are; Shortness of breath, fatigue, or swelling of the feet, ankles, legs, abdomen, or neck veins
These symptoms may present when you’re doing regular daily activities or when at rest.6 Call your doctor immediately if you notice these symptoms or if they become worse.
Risk factors of heart disease in women
Women are more likely to have certain risk factors for heart disease. Several other medical conditions and lifestyle choices can also put women at a higher risk for heart disease, including:7
- Family history
- Preeclampsia during pregnancy
- Sleep apnea
- Autoimmune conditions
- High blood pressure
- High cholesterol
Some lifestyle factors that can increase your risk of heart disease include:
- Overweight or obesity
- Stress and depression
- Physical inactivity
- Eating an unhealthy diet
- Drinking too much alcohol
Treatment and prevention
Treatment for heart disease in women
Women have smaller coronary arteries than men.2 The choice of treatment will vary depending on the type of heart disease a person has, but some common strategies include making lifestyle changes, taking medications, and undergoing surgery.
Medication can help treat heart conditions. The main options include:8
- Calcium channel blockers: These act by reducing the pumping strength of the heart and relaxing the blood vessels. An example is diltiazem
- Angiotensin Receptor-Neprilysin Inhibitors (ARNIs): These medications help to improve artery opening and blood flow, reduce sodium retention, and decrease pressure on the heart. They are used for the treatment of heart failure. An example is Sacubitril/valsartan
- Anticoagulants: These medications help to prevent clots. They are also known as blood thinners, Examples are warfarin, dabigatran, rivaroxaban, and apixaban
- Antiplatelet therapies: These also prevent clots from forming in your artery. An example is aspirin.
- Vasodilators: These medications act by relaxing the blood vessels thus helpful in lowering blood pressure. They are also used to ease chest pain. An example is Nitroglycerin
- Angiotensin-converting enzyme inhibitors: These prevent your body from forming angiotensin, a hormone that can cause your blood vessels to constrict, resulting in high blood pressure. An example is Lisinopril
- Angiotensin II receptor blockers: These help to control blood pressure. An example is Losartan
- Digitalis Preparations: This can help to Increase the force of the heart's contractions. They are also beneficial in treating heart failure and irregular heartbeats. Digitalis preparations are used to relieve heart failure symptoms and slow certain types of irregular heartbeat. An example is digoxin
- Cholesterol-lowering medications: These can help reduce your “bad” cholesterol (LDL) and increase your “good” cholesterol (HDL). Examples are Statins
- Beta-blockers: These drugs can reduce the heart rate and lower blood pressure. They are also used to treat arrhythmias and angina. An example is Metoprolol
- Diuretics: These drugs help to reduce the heart’s workload, lower blood pressure, and remove excess water from the body. An example is Furosemide
Other treatments for heart disease besides medication may include the following:
- Coronary bypass surgery
- Coronary angiography
- Device implantation
- Laser treatment
- Maze surgery
- Repair surgery
- Cardiac stent
Prevention for heart disease in women
Women have the power to act and reduce their heart disease risk. Many risk factors are preventable or controlled with treatment. Several things in your control can help reduce your risk for heart disease. 9,10
- Don't smoke (actively or passively): You increase your chance of having a heart attack if you smoke as few as one to four cigarettes per day. Regular exposure to someone else's smoke can increase your risk even if you don't smoke
- Be more active: Exercise regularly or get at least 30 minutes per day of moderate-intensity exercise, like brisk walking, most days. Add more fit activity into your life: Take the stairs, do yard work, park farther from your destination and walk
- Eat a healthy and well-balanced diet: Several studies have identified many crucial ingredients of a heart-healthy diet such as whole grains, a variety of fruits and vegetables, nuts, poly-, and monounsaturated fats, fatty fish (like wild salmon), and limited intake of trans-fats
- Reduce stress and treat depression: Stress and depression can increase your risk of heart disease according to studies. Stress-reducing strategies you can adopt include exercise, adequate sleep, relaxation techniques, and meditation. Psychotherapy can be helpful with depression and anxiety
- Know your numbers: According to the American Heart Association (AHA), you can reduce your risk for these heart diseases by maintaining certain body measurements and levels of cholesterol and blood pressure
- Limit alcohol intake: According to the Centers for disease control (CDC) Women should consume no more than one standard drink per day, and men should consume no more than two standard drinks per day
Heart disease remains underrated by both women and doctors. Social stigma is a major barrier to women not discussing heart health to take action to reduce the risk. Every disease deserves attention and action. But you must learn about the symptoms and risk factors of heart disease to help you take steps to reduce your risks such as eating a healthy diet, exercising, managing your blood sugar and blood pressure not to go high, stopping smoking and alcohol consumption, and weight control.
Discuss with your healthcare provider today how you can make changes to reduce your risk of heart disease one step at a time.
- CDC. Women and heart disease [Internet]. Centers for Disease Control and Prevention. 2022 [cited 2022 Dec 2]. Available from: https://www.cdc.gov/heartdisease/women.htm
- Feldman R. Heart disease in women: unappreciated challenges, gper as a new target. IJMS [Internet]. 2016 May 18 [cited 2022 Dec 2];17(5):760. Available from: http://www.mdpi.com/1422-0067/17/5/760
- Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics—2019 update: a report from the American heart association. Circulation [Internet]. 2019 Mar 5 [cited 2022 Dec 2];139(10). Available from: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000659
- Gooding HC, Brown CA, Revette AC, Vaccarino V, Liu J, Patterson S, et al. Young women’s perceptions of heart disease risk. Journal of Adolescent Health [Internet]. 2020 Nov [cited 2022 Dec 2];67(5):708–13. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1054139X20302299
- Coronary heart disease - what is coronary heart disease? | nhlbi, nih [Internet]. [cited 2022 Dec 2]. Available from: https://www.nhlbi.nih.gov/health/coronary-heart-disease
- Angina (Chest pain) - symptoms | NHLBI, NIH [Internet]. [cited 2022 Dec 2]. Available from: https://www.nhlbi.nih.gov/health/angina/symptoms
- Manson JE, Colditz GA, Stampfer MJ, Willett WC, Rosner B, Monson RR, et al. A prospective study of obesity and risk of coronary heart disease in women. N Engl J Med [Internet]. 1990 Mar 29 [cited 2022 Dec 2];322(13):882–9. Available from: http://www.nejm.org/doi/abs/10.1056/NEJM199003293221303
- Types of heart medications [Internet]. www.heart.org. [cited 2022 Dec 2]. Available from: https://www.heart.org/en/health-topics/heart-attack/treatment-of-a-heart-attack/cardiac-medications
- Gender matters: Heart disease risk in women [Internet]. Harvard Health. 2006 [cited 2022 Dec 2]. Available from: https://www.health.harvard.edu/heart-health/gender-matters-heart-disease-risk-in-women
- Drinking too much alcohol can harm your health. Learn the facts | CDC [Internet]. 2022 [cited 2022 Dec 2]. Available from: https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm