What women need to know about heart disease

According to the American Heart Association, heart disease is the number one killer of women. For women, menopause and other factors come into play to increase their risk. It’s important to understand the different types of heart disease common in women and the lifestyle changes necessary to improve your heart health.

Coronary Heart Disease
According to Dr. Archana Goel, an internal medicine physician at Advocate Sherman Hospital, coronary heart disease (CHD) is the most common type of heart disease. In CHD, plaque build-up on the inside walls of the coronary arteries causes narrowing, reducing blood flow to the heart.

“The risk for CHD increases with age,” Dr. Goel says. “Women tend to have CHD about 10 years later than men with similar risk factors.” The risk for heart disease increases dramatically once a woman reaches the natural age of menopause (50–52 years old). At age 70 and beyond, men and women are at equal risk for heart disease, Dr. Goel says.

For women, the most common symptom of CHD is angina, which can be described as chest pressure, tightness or heaviness. It can radiate to other areas of the body, including the left shoulder, arm, neck, back or abdomen. “For women, angina is often atypical and can feel like sharp chest pain,” Dr. Goel says. “These symptoms can occur during day-to-day activities such as cooking, cleaning and shopping or while sleeping.”

Other symptoms include nausea, shortness of breath, rapid heartbeat, extreme fatigue and sweating. It is important for women to see their doctor or call 911 if these symptoms occur.

Generally, women have the same risk factors for heart disease as men: high blood pressure, diabetes, high cholesterol, smoking, obesity and a family history of heart disease. “Birth control pills and menopause also increase the risk of CHD in women,” Dr. Goel says.

Coronary Microvascular Disease
A type of heart disease more common in women is coronary microvascular disease (MVD), in which tiny arteries in the heart become damaged. “Many researchers think that a drop in estrogen during menopause, combined with other heart disease risk factors, causes MVD,” Dr. Goel says. A drop in estrogen also causes changes in lipid (fat) levels resulting in higher LDL (bad cholesterol) and lower HDL (good cholesterol). “These changes lead to a buildup of plaque in the coronary arteries,” Dr. Goel says. 

Broken Heart Syndrome
Women are also more likely to suffer from broken heart syndrome, or takotsubo cardiomyopathy. In this condition, an increase in stress hormones causes the heart to enlarge. “Emotional stress leads to heart muscle failure,” Dr. Goel says. “It is often severe, but a temporary condition. Most people make a full recovery with medical treatment.”

No matter your age, it is never too late to start living a heart-healthy lifestyle to avoid heart disease later in life. “Though the risk of CHD increases with age, women of all age groups, especially those with risk factors for CHD, should be concerned about heart disease and take appropriate measures to prevent it,” Dr. Goel says.