Heart disease is the leading cause of death among women in the United States, according to the U.S. Centers for Disease Control. However, it has historically been thought of as a “man’s disease" — even if the statistics indicate otherwise.
The term heart disease or cardiovascular disease refers to several different conditions, the most common being coronary heart disease, which often go undiagnosed until someone has a heart attack, per the CDC.
The good news is that heart disease can largely be prevented by making lifestyle changes and managing risk factors — but early detection is key. The signs of heart disease can look different in women and too often get overlooked or go undiagnosed as a result.
"It’s very, very important to recognize that women ... can have heart disease, too," Dr. Icilma Fergus, director of cardiovascular disparities at Mount Sinai Medical Center, tells TODAY.com.
February is American heart month, a time to increase awareness and promote heart-healthy habits. We spoke to female cardiologists about the top mistakes they see women making when it comes to heart health and how to avoid them.
Know your heart disease risk factors
Everyone should know which risk factors they have that increase their risk of heart disease, says Fergus. Risk factors you can control are called "modifiable" and include high blood pressure, high cholesterol, smoking or weight. Non-modifiable risk factors include age, sex assigned at birth and your genes.
Nearly half of all Americans have at least one of the top three risk factors for heart disease — high blood pressure, high cholesterol and smoking — according to the CDC.
“Heart disease can be 80% preventable if you’re managing some of these early on,” says Fergus.
To do so, be sure to find out your blood pressure, blood sugar and LDL cholesterol levels at routine check-ups, Dr. Michelle O’Donoghue, a cardiologist at Brigham and Women’s Hospital in Boston, tells TODAY.com.
"You should have a fasting blood sugar of less than 100 (mg/dL), a good cholesterol above 50 (mg/dL), and the LDL or bad cholesterol should be less than 100 (mg/dL)," says Fergus.
This is especially important for post-menopausal women, as the risk of heart attack increases once a woman enters her menopausal years, says O’Donoghue.
Don't shrug off high blood pressure readings
High blood pressure or hypertension occurs when the force of the blood running through your arteries is consistently high, per the CDC, which can increase the risk of a heart attack.
“The cumulative effect over time of high blood pressure is incredibly bad for your heart and many other organs, so I think it’s really important to take it very seriously as soon as it’s diagnosed,” Dr. Jennifer Haythe, a cardiologist at Columbia University Irving Medical Center, tells TODAY.com.
A normal blood pressure level is between 110 to 130 over 70 to 80 (mmHg), says Fergus. The experts encourage anyone with high blood pressure to talk to their doctor about how to best manage it, whether that's through medication, lifestyle changes or a combination.
Don't think you're too young for heart disease
According to the CDC, heart disease is happening to younger adults more and more often because the conditions that lead to heart disease are occurring in more young people.
“Heart disease can occur at any age ... as early as a teen all the way until the 80s," says Fergus, adding that heart disease may manifest differently at different ages.
For women of childbearing age, cardiovascular disease is the leading cause of pregnancy complications and responsible for one-third of pregnancy-related deaths in the U.S., according to the Cleveland Clinic.
Don't overlook your family history
"I would always try to know my family history if possible," says Haythe, as a family history of heart disease increases your own risk.
Talk to your parents, siblings, grandparents, aunts and uncles about "whether they have had any kind of cardiac events, sudden cardiac death or what other risk factors they have," says Fergus.
"You can’t change your genetics. However, you can educate yourself about what conditions are present in your family ... and prepare yourself against that," says Fergus.
Know that chest pain isn't the only warning sign
"Obviously, I would never ignore chest pain," says Haythe. However, the signs of heart problems can be much more subtle and varied, especially in women, compared to what you see in movies or TV.
"There is always this mistaken belief that heart attack just feels like classic pain in the chest, but typically it's described as a pressure or heaviness or discomfort," says O’Donoghue, adding that it may feel like someone is sitting on your chest.
People may also experience a racing heartbeat, shortness of breath or dizziness, says Fergus.
Other signs of heart problems never to ignore include:
- Pain radiating to the neck or arm
Other symptoms of heart disease in women include fatigue, heartburn, sudden sweating, nausea, a feeling of fullness in the chest, and pain in the back, jaw or abdomen.
Don't drink alcohol excessively
“Alcohol in general is not good for your heart,” says Haythe.
Drinking in moderation is defined by the CDC as two drinks or fewer a day for men and one drink a day for women.
Although some studies have shown that consuming small amounts of red wine may have health benefits due to compounds like resveratrol, says Fergus, alcohol of any type can still be toxic.
Large amounts of alcohol can harm the heart muscle, impair judgement and increase risk of heart attack and stroke.
Don't smoke or vape
Smoking causes one-fourth of deaths from cardiovascular disease in the U.S., per the CDC. It makes blood more likely to clot and can cause a buildup of plaque in the blood vessels.
"Now a lot of people are into vaping, but any amount of inhalants is not good," says Fergus. "The nicotine (in vapes) can cause a racing heart, and you can end up with ... irregular heartbeats."
If you do smoke, it's important to be honest with your doctor so you can better understand and manage your risk factors.
Try to get enough sleep
"I would make sleep a priority... as a cardiologist, I really try to get some eight hours of sleep if possible," says Haythe. Consistently sleeping less than seven hours a night has been linked to health problems, such as high blood pressure, that can increase your risk of heart disease and heart attacks, per the CDC.
The quality of your sleep matters, too. Some people may have undiagnosed sleep apnea, O’Donoghue adds, which puts additional stress on the heart. "If your partner says that you are a loud snorer or has heard you stop breathing for periods of time at night, you might want to consider a sleep study," she says.
Don't let stress and anxiety go uncontrolled
Stress and anxiety elevate your levels of the hormone cortisol, which can increase your blood pressure and heart rate, says Fergus. Whether you have chronic stress and anxiety or sudden bursts, it's not helpful for the heart and shouldn't go uncontrolled, she adds.
"Find things to do that you love and that relax you and always make sure there’s downtime in your day ... even if you have a highly stressful job," says Fergus.
A final word on women and heart health
There are misconceptions and biases about heart disease held by both the general public and physicians, O’Donoghue says, which is why it’s important to speak up — even in the doctor’s office.
O'Donoghue encourages women "to be their own best advocate" and "to trust their instincts ... if they feel like something is not right."
"All too often, women’s symptoms get inappropriately chalked up to to something else," she adds. “Don’t be afraid to ask your doctor questions."
And, as much as possible, don't let your responsibilities of caring for your children, spouse or co-workers prevent you from taking care of yourself or seeking medical care in a timely fashion if you think something is wrong, Fergus says.
Like they tell you on an airplane, "Put on your own mask first ... and take care of yourself. Then you'll be in a better place to help others," Fergus adds.