Heart disease is the number one cause of death in America for both men and women. Despite this fact, many women don’t seriously consider their risk for heart disease.
Some of this gender awareness gap stems from popular media. TV shows and movies tend to portray heart attacks and stroke as primarily male concerns. In 2019, an American Heart Association survey found that only 44% of women correctly named heart disease as the leading cause of death facing females in the U.S.
Social media campaigns, such as the American Heart Association’s Go Red for Women project, have increased awareness of women’s risk of heart disease. But there’s more work to do.
Symptom Disparities in Women and Men
Heart disease can present differently in women than in men. This makes it challenging for some women to realize when they’re experiencing cardiovascular symptoms.
Both men and women tend to experience chest discomfort during a heart attack. Both genders also frequently report feeling pain or discomfort in the left arm, jaw, neck or back when having a heart attack.
But women also often feel symptoms not always reported in men, including nausea, vomiting, lightheadedness or sudden fatigue, says Erica Pivato, DO, a St. Elizabeth Healthcare cardiologist. In a study of roughly 3,000 patients who experienced a recent heart attack, women were less likely to immediately associate their symptoms with a heart condition, according to LiveScience.
Similarly, in cases of stroke, women often have symptoms not typical for men, including migraines, nausea and loss of consciousness.
The Danger of Delayed Care
Differing symptoms can cause some women to delay seeking care for a cardiovascular event. It can also lead to women getting the wrong diagnosis when they do seek treatment.
“There is some evidence that shows women are less likely to survive a heart attack than men,” Pivato says. These poorer health outcomes could be linked to women’s tendency to wait to have symptoms checked. Some research suggests women wait nearly four times longer than men to have chest pain symptoms evaluated.
“When women wait too long, their outcomes may be worse because they could develop complications such as a scar on the heart, which can lead to things like congestive heart failure,” Pivato explains.
Even when women do seek care for a cardiac event, studies have found that women are less likely to stay on prescribed medications to prevent future attacks.
“I think women are more prone to having side effects and it really deters us from taking some of these medications that are needed to prevent another heart attack and keep us safe,” Pivato says.
The Importance of Inclusive Research
In the past, medical guidelines specific to men informed doctors’ understanding of heart disease.
Today, heart disease research is more inclusive. This is helping cardiovascular specialists better understand the specific and unique ways that heart disease appears in women. The hope is that more detailed research can improve health outcomes for everyone.
This new approach recognizes that female heart health has key biologic differences, including women’s experience of pregnancy and menopause.
Advocates behind this initiative, including the American Heart Association, have identified five key goals in closing the women’s heart health gap:
- Advance sex-specific research – Moving away from a one-size-fits-all research model to focus on gender-specific differences in cardiovascular disease.
- Improve routine health data collection – Ensuring health data is equitably collected to cover all age groups, races and ethnicities.
- Educate healthcare providers – Encouraging physicians to approach women’s cardiovascular health as a shared responsibility.
- Raise public awareness – Getting the word out about women’s cardiovascular risk factors and prevention strategies.
- Invest in women’s heart health –Supporting businesses that endorse women’s cardiovascular care.
How Stress Affects Women’s Heart Health
Women typically self-report feeling higher levels of chronic stress compared to men. Stress is a known risk factor for heart disease since it causes the body to release cortisol. Over time, this can lead to high blood pressure and elevated cholesterol levels.
“Stress has a huge impact on major adverse cardiac events, so it’s really important to control it,” says Pivato. “An extremely stressful event can actually lead to something like a heart attack or stroke.”
Long-term stress can also lead to weight gain, which contributes to heart disease risk. “It also leads to unhealthy habits, like not eating correctly and not taking care of yourself,” Pivato adds.
Left unchecked, a feeling of overwhelming stress can eventually spiral into anxiety or depression, which are also known contributors to increased heart disease risk.
To maintain heart health, women (and men) can take steps to help reduce stress, including:
- Listening to music.
- Practicing meditation.
- Taking a walk.
- Trying breathing techniques.
- Writing in a journal.
Implementing personal care techniques can help break patterns of chronic stress. In the process, this can lower the long-term risk of heart attack or stroke.
Learn more about the unique challenges women face when it comes to heart health at Women and Heart Health.
