Heart disease can strike women at any age, so you need to know the risk factors. In fact, some heart disease risk factors, such as diabetes, are greater for women than for men.
Medically Reviewed by Lindsey Marcellin, MD, MPH
If you think heart disease is a man’s disease, think again — it’s the leading killer of women of all ages.
To protect your heart health, it’s important to know heart disease risk factors, such as high blood pressure and obesity. And here’s something else to keep in mind: Some risk factors play a bigger role among women than they do in men.
“Women should always be thinking about their leading health care threat,” says Noel Bairey Merz, MD, director of the Women’s Heart Center at the Cedars-Sinai Heart Institute in Los Angeles.
Although the average age for a woman to have a heart attack is in her early seventies, heart disease is a threat at any age. “More 22-year-olds die of heart disease than breast cancer,” Dr. Bairey Merz says.
To take stock of your heart health, understand your heart disease risk factors.
Traditional Heart Disease Risk Factors
These are factors that affect risk for heart disease in women at about the same rate as men:
- Your age. More than 83 percent of people who die of heart disease are age 65 or older.
- Your family history. If you have a parent who has or had heart disease, you’re more likely to get it. Risk also tends to be higher for African Americans, Mexican Americans, Native Americans, Native Hawaiians, and some Asian Americans.
- High blood pressure. When you have high blood pressure, your heart has to work harder and your risk for heart disease goes up.
- High cholesterol. Your risk for heart disease also goes up when your blood cholesterol level goes up.
- Obesity. Even when you don’t have other risk factors, being overweight or obese raises your risk of heart disease, particularly if you have fat around your midsection.
- Metabolic syndrome. By definition, having a combination of three or more of these symptoms — a large waistline, insulin resistance, low levels of “good” cholesterol, and elevated triglyceride levels — raises the risk for heart disease, but the risk between men and women is equal, Bairey Merz says. Metabolic syndrome also raises the risk for diabetes.
Heart Disease Risk Factors That Play a Bigger Role in Women
These factors affect both men and women, but doctors are finding that they may have a bigger impact on women:
- Diabetes. This in particular is a more potent risk factor for women. Women who have diabetes have a four to five times more elevated risk for heart disease, says Bairey Merz. Meanwhile, men who have diabetes have two times the risk of heart disease as those without diabetes.
- Low estrogen levels. Part of the reason diabetes plays a bigger role in women’s risk has to do with estrogen levels. Women who are relatively young and have diabetes tend to have an abnormal ovulation cycle and a lower estrogen level. This is often due to polycystic ovary syndrome (PCOS), and older women who have diabetes are also more likely to have some history of an imbalance in women’s hormones. Women with a history of PCOS are at higher risk for diabetes and heart disease. Experts do not fully understand the connection between estrogen and heart health. Research on heart disease in women has lagged behind research on men’s heart disease, but this is an example of why more studies need to focus on women, says Bairey Merz.
- Smoking. People who smoke are two to four times more likely to develop heart disease, and each cigarette may have a bigger impact on women. “If you look at an average man and an average woman smoking a pack a day, because women are smaller on average, they’ll get a relatively higher dose of cigarette smoke and be more impacted by it,” Bairey Merz says.
- Depression. Depression isn’t an independent risk factor for heart disease, but it is associated with higher risk. Doctors don’t yet know if there’s a biological basis for the association or if it’s because people who are depressed are more likely to smoke, skip exercise, eat unhealthy foods, and miss doctor’s appointments, which may lead to an increased heart disease risk. More women than men experience depression, so it may have a bigger impact on women’s risk.
Heart disease isn’t something women should ignore. Take stock of your heart health and do as much as you can to lower your risk, to keep your heart healthy for years to come.