Although most women fear breast cancer more than cardiovascular disease, the risk of a woman dying of cardiovascular disease is far higher. As with men, cardiovascular disease is still the number one cause of death in women. According to Harvard Health, a woman has a 1 in 31 risk of dying of breast cancer but 1 in 3 odds of dying of heart disease! Therefore, we need to focus on cardiovascular risk, just as we do on lowering our risk of breast cancer. Fortunately, lifestyle habits that reduce one also lowers the risk of the other. For example, exercise, not smoking, and consuming more plant-based and fiber-rich foods is beneficial for both.
Cardiovascular disease is a general term that refers to several conditions that affect the heart and blood vessels. These include heart attacks, coronary artery disease, stroke, and heart failure. There’s no sure-fire way to prevent cardiovascular disease, although it’s a condition very much influenced by lifestyle habits. Research suggests that up to 80% of cases of cardiovascular disease can be prevented through lifestyle factors. The key is to know your risk factors and have a plan to mitigate those risks through lifestyle habits.
However, there is still a lot of misinformation about women and heart disease. Here are some facts that may surprise you.
Women Can Develop a Heart Attack with No Prior Symptoms
Women are less likely to experience classic signs or symptoms of a heart attack relative to men. In fact, women can feel perfectly fine until the day they experience a heart-damaging blockage. When they do experience heart disease symptoms, the symptoms may be vague and include fatigue, indigestion, nausea, or lightheadedness rather than chest pain and shortness of breath. This can lead to a delay in diagnosis and may explain why women have a worse prognosis than a man when they have a heart attack.
Age at Menopause Influences the Risk of Developing Heart Disease
Women who go through menopause early have up to double the risk of developing a stroke or heart attack than women who transition into menopause later. Entering menopause before the age of 45 is considered early from a cardiovascular disease standpoint. In fact, women who enter menopause before age 45 have around a 25% higher risk of heart disease relative to women who enter menopause later. You can’t control when you go through menopause, but you can work harder to lead a healthy lifestyle if you enter early.
Women Are More Prone to Small Vessel Disease
The main blood vessels that carry blood to the heart are called the coronary arteries. Clogging of these vessels or rupture of a plaque within one of the blood vessels is what typically leads to a heart attack, particularly in men. However, women can develop small vessel disease, a condition where the smaller blood vessels that feed into the coronary arteries become narrowed or damaged. Small vessel disease is less likely to cause the classic symptoms of heart attack, like chest pain and shortness of breath.. Instead, people with small vessel disease may complain of fatigue, lightheadedness, dizziness, and other vague symptoms.
Women Can Have Heart Attacks Before Menopause
That younger women don’t have heart attacks is a common myth. Heart attacks and strokes are less common in women before menopause , but they do occur, particularly in women who smoke. In fact, the rate of heart attacks is on the rise in people in their 20s and 30s, including women. It’s not clear why, but increasing rates of substance abuse may play a role. In addition, women who have diabetes or hypertension before menopause are at increased risk.
Hormone Replacement Therapy is Controversial
These days, most physicians don’t recommend that women take hormone replacement therapy for the purpose of preventing heart disease. Although recent research suggests that it may have some protective benefits if you start early enough. However, there is not enough evidence to recommend it specifically for the prevention of cardiovascular disease. There are reasons not to use hormone replacement therapy except short-term for relief of menopausal symptoms. The Women’s Health Initiative linked the use of hormone replacement therapy (combined therapy with estrogen and progestins) with a higher risk of breast cancer, stroke, blood clots in the lung, and even cardiovascular disease.
However, it’s important to have a discussion with your own physician about whether hormone replacement therapy is right for you. Each person is different and they may recommend short-term use of hormone replacement therapy if you’re having disabling symptoms.
Being Physically Fit Doesn’t Eliminate the Risk of Heart Disease
We know that exercise is a heart-healthy habit and that staying physically active substantially lowers the risk of developing a heart attack or stroke. But it doesn’t eliminate it. Being physically active can give us a false sense of security. Even if you never miss a workout, it’s still important to follow your blood pressure, fasting blood sugars, and lipids. Also, physical activity lowers the risk the most if you combine it with a whole food diet that includes fruits, vegetables, nuts, and whole grains.
Also, know your family history. If you have close relatives who had a heart attack or stroke before age 70, you’re at higher risk. Still, lifestyle can have a big impact on lowering that risk. So, make an action plan to help you reduce your risk. You can use online risk calculators to determine your own future risk of developing a heart attack.
The Bottom Line
Women need to worry about heart disease too. Fortunately, your risk of developing it is strongly linked to the lifestyle you lead. You’re already a step ahead if you don’t engage in bad habits like smoking or consuming large amounts of alcohol. Plus, you can lower your risk more through physical activity and diet. Take advantage of the things you can control and know your own personal risk of developing heart disease. It could save your life and your health!
· Today’s Dietitian. Vol. 20, No. 9, P. 34. September 2018.
· Curr Atheroscler Rep. 2018 Oct 22;20(12):57. doi: 10.1007/s11883-018-0758-2.
· Live Science. “Why Are More Young People Having Heart Attacks?”
· Harvard Health Publishing. “Heart disease and breast cancer: Can women cut risk for both?”
· Endocrine News. “Premature or Early-Onset Menopause Associated with Increased Risk of Coronary Heart Disease, Mortality”