About Women and Heart Disease

Key points

  • Heart disease is the leading cause of death for women in the United States and can affect women at any age.
  • High blood pressure is a major risk factor for heart disease.
Female doctor talking with her senior patient

Overview

Over 60 million women (44%) in the United States are living with some form of heart disease.1 Heart disease is the leading cause of death for women in the United States and can affect women at any age.

In 2021, it was responsible for the deaths of 310,661 women—or about 1 in every 5 female deaths.2 Only about half (56%) of US women recognize that heart disease is their number 1 killer.3

Knowing the facts about heart disease—as well as the signs, symptoms and risk factors—can help you take steps to protect your health and seek proper treatment if you need it.

Types

Coronary artery disease: The most common heart disease is caused by plaque in the walls of the arteries that supply blood to your heart and other parts of your body. After menopause, women are at a higher risk of coronary artery disease because of hormonal changes.4

Arrhythmia: This condition is when your heart beats too slowly, too fast, or in an irregular way. A common example is atrial fibrillation.

Heart failure: Heart failure is when your heart is too weak to pump enough blood to support other organs in your body. This condition is serious, but it doesn't mean your heart has stopped beating.

Symptoms

Although some women have no symptoms,4 others may have:

  • Angina—usually felt as a dull or heavy chest discomfort or ache.
  • Pain in the neck, jaw, or throat.
  • Pain in the upper abdomen or back.

These symptoms may happen when you're resting or active. Women also may have other symptoms,4 including:

  • Nausea.
  • Vomiting.
  • Tiredness that won't go away or feels excessive.

When to call 9-1-1

In some women, the first signs and symptoms of heart disease can be:

  • Heart attack: Chest pain or discomfort, upper back or neck pain, indigestion, heartburn, nausea or vomiting, extreme fatigue, dizziness, and shortness of breath.
  • Fluttering feelings in the chest (palpitations).
  • Shortness of breath, sudden fatigue, or swelling of the feet, ankles, legs, or abdomen.

If you have any of these symptoms, don't delay. Call 9-1-1 right away.

Risk factors

High blood pressure is a major risk factor for heart disease. More than 58.9 million women in the United States (45.7%) have high blood pressure (defined as 130/80 mm Hg or higher) or are taking blood pressure medicine. 5This includes almost 1 in 5 women of reproductive age.6

Having high blood pressure increases the risk of developing heart disease and stroke and can lead to early death.67 High blood pressure is often underdiagnosed in women, and fewer than 1 in 4 women with high blood pressure (22.8%) have their condition under control.5

Black women are nearly 60% more likely to have high blood pressure than White women.8 Pregnant women with high blood pressure have twice the risk of developing heart disease later in life compared to pregnant women without this condition.8 In the United States, high blood pressure develops in 1 in every 8 (13.0%) pregnancies.9

Several other medical conditions and lifestyle choices can put women at higher risk of heart disease,4 including:

  • High LDL (low-density lipoprotein) cholesterol
  • Smoking
  • Diabetes
  • Excess weight
  • An unhealthy diet
  • Physical inactivity
  • Drinking too much alcohol
  • Stress and depression

Women also face specific factors related to reproductive health and pregnancy,910111213 including:

  • Early first period (before age 11)
  • Early menopause (before age 40)
  • Polycystic ovary syndrome
  • Diabetes during pregnancy (gestational diabetes)
  • Preterm delivery
  • Delivery of a low birth weight or high birth weight infant
  • Hypertensive disorders of pregnancy

Cardiovascular conditions during pregnancy can also increase a woman's risk of heart disease and pregnancy-related complications. Find out more about these conditions and what you can do to prevent them or reduce their long-term effects:

Reducing risk

Know your blood pressure. Having uncontrolled blood pressure can lead to heart disease, stroke, kidney failure, and dementia. High blood pressure has no symptoms. It's important to check your blood pressure regularly and report elevated readings to your health care team.

Talk to your doctor or health care team about whether you should be tested for diabetes. Having uncontrolled diabetes raises your risk of heart disease.9

Quit smoking. If you don't smoke, don't start. If you do smoke, learn ways to quit.

Talk to your doctor about checking your cholesterol and triglycerides.

Get at least 150 minutes of physical activity each week. Even short "doses" of activity are good for your heart.

Make healthy food choices. Having overweight or obesity raises your risk of heart disease.

Limit how much alcohol you drink to one drink a day. If you're pregnant, don't drink any alcohol. There is no safe time for alcohol use during pregnancy.

Manage stress levels by finding healthy ways to cope with stress.

Resources

  1. Tsao CW, Aday AW, Almarzooq ZI, et al. Heart disease and stroke statistics–2023 update: a report from the American Heart Association. Circulation. 2023;147(8):e93–e621.
  2. National Center for Health Statistics. Multiple Cause of Death 2018–2021 on CDC WONDER Database. Accessed February 2, 2023. https://wonder.cdc.gov/mcd.html
  3. Mosca L, Hammond G, Mochari-Greenberger H, Towfighi A, Albert MA, American Heart Association Cardiovascular Disease and Stroke in Women and Special Populations Committee of the Council on Clinical Cardiology, Council on Epidemiology and Prevention, Council on Cardiovascular Nursing, Council on High Blood Pressure Research, and Council on Nutrition, Physical Activity and Metabolism. Fifteen-year trends in awareness of heart disease in women: results of a 2012 American Heart Association national survey. Circulation. 2013;127(11):1254–1263, e1–e29.
  4. National Heart, Lung, and Blood Institute. Women and heart disease. Accessed November 10, 2022. https://www.nhlbi.nih.gov/health/coronary-heart-disease/women
  5. Centers for Disease Control and Prevention. Estimated hypertension prevalence, treatment, and control estimates among US adults. Accessed Feb 24, 2022. https://millionhearts.hhs.gov/data-reports/hypertension-prevalence.html
  6. Ford ND, Robbins CL, Hayes DK, Ko JY, Loustalot F. Prevalence, treatment, and control of hypertension among US women of reproductive age by race/Hispanic origin. Am J Hypertens. 2022;35(8):723–730. doi:10.1093/ajh/hpac053
  7. Bateman BT, Shaw KM, Kuklina EV, Callaghan WM, Seely EW, Hernandez-Diaz S. Hypertension in women of reproductive age in the United States: NHANES 1999-2008. PLoS One. 2012;7(4):e36171.
  8. Ostchega Y, Fryar CD, Nwankwo T, Nguyen DT. Hypertension prevalence among adults aged 18 and over: United States, 2017–2018. NCHS Data Brief. 2020;(364):1–8.
  9. Ford ND, Cox S, Ko JY, et al. Hypertensive disorders in pregnancy and mortality at delivery hospitalization – United States, 2017-2019. MMWR Morb Mortal Wkly Rep. 2022;71(17):585–591. doi:10.15585/mmwr.mm7117a1
  10. O'Kelly AC, Michos ED, Shufelt CL, et al. Pregnancy and reproductive risk factors for cardiovascular disease in women. Circ Res. 2022;130(4):652–672. doi: 10.1161/CIRCRESAHA.121.319895
  11. Brown HL, Warner JJ, Gianos E, et al.; American Heart Association and the American College of Obstetricians and Gynecologists. Promoting risk identification and reduction of cardiovascular disease in women through collaboration with obstetricians and gynecologists: a Presidential Advisory from the American Heart Association and the American College of Obstetricians and Gynecologists. Circulation. 2018;137(24):e843–e852. doi:10.1161/CIR.0000000000000582
  12. Wang MC, Freaney PM, Perak AM, et al. Trends in prepregnancy cardiovascular health in the United States, 2011-2019. Am J Prev Cardiol. 2021;7:100229. doi:10.1016/j.ajpc.2021.100229
  13. Perak AM, Lancki N, Kuang A, et al.; HAPO Follow-Up Study Cooperative Research Group. Associations of maternal cardiovascular health in pregnancy with offspring cardiovascular health in early adolescence. JAMA. 2021;325(7):658–668. doi:10.1001/jama.2021.0247