Office of Women's Health

Facts About Cardiovascular Disease

Do women really need to worry about cardiovascular disease?

Heart disease is not just a man’s disease. Heart attack, stroke and other cardiovascular diseases are devastating to women, too. In fact, coronary heart disease, which causes heart attacks, is the leading cause of death for American women. Many women believe that cancer is more of a threat, but they are wrong. Nearly twice as many women in the United States die of heart disease and stroke than from all forms of cancer, including breast cancer.

  • In 2003 in the United States, cardiovascular diseases claimed the lives of 483,842 women.
  • In an average year, 42,540 Illinoisans, about half of which are women, will die of cardiovascular disease.
  • One in five females has some form of heart or blood vessel disease.
  • 38 percent of women die within a year after having a heart attack, as compared to 25 percent of men.
  • During the first six years after a recognized heart attack, the rate of having a second attack is 35 percent for women and 18 percent for men.

How do I know if I have cardiovascular disease?

Cardiovascular disease can be silent, but usually has symptoms. Lack of blood flow to the heart muscle can cause symptoms of chest discomfort or pain, shortness of breath, fatigue and sometimes palpitations and dizziness. Talking to your doctor about your symptoms, along with good routine medical care, are necessary first steps to determine if further evaluation is necessary. Many cardiac risk factors can be controlled, modified or eliminated, including hypertension, diabetes, elevated cholesterol, smoking and obesity/physical inactivity.

What factors increase my chances for cardiovascular disease?

The three biggest risk factors for cardiovascular disease that you can do something about are cigarette smoking, high blood pressure and elevated blood cholesterol levels. Other risk factors, such as being overweight or having diabetes, also are conditions over which you have some control. Even just one risk factor will raise your chances of having heart-related problems. The more risk factors you have, the more likely you are to develop cardiovascular diseases. Studies show that physical inactivity is a risk factor for heart disease. Physically active women have approximately 60 percent to 75 percent lower risk of heart disease than women who are not active. Physical activity includes daily walking, climbing stairs, gardening, etc. Unfortunately, more than half of all women in the United States are physically inactive. Excess body weight in women is linked with coronary heart disease, stroke, congestive heart failure and death from heart-related causes. The more overweight you are, the higher your risk for heart disease.

Diabetes, or high blood sugar, is a serious disorder that raises the risk of coronary heart disease. The risk of death from heart disease is about three times higher in women with diabetes. Diabetic women also are more apt to have high blood pressure and high blood cholesterol. The risk of heart attack or stroke is higher for women who both smoke and use high-dose birth control pills (oral contraceptives).

What other factors contribute to the risk of cardiovascular disease in women?

Menopause and estrogen loss — Many scientists believe that estrogen, a hormone produced in a woman’s body, offers some protection against heart disease, but this theory has yet to be proven. There is less evidence that estrogen may protect against stroke. Several population studies show that the loss of natural estrogen as women age may contribute to a higher risk of heart disease after menopause. If menopause is caused by surgery to remove the uterus and ovaries, the risk rises sharply. If menopause occurs naturally, the risk rises more slowly.

Birth control pills — Today’s low-dose oral contraceptives carry a much lower risk of heart disease and stroke than early contraceptives did. The exception is in women who smoke or have high blood pressure.

High triglyceride levels — Triglyceride is the most common type of fat in the body. A high triglyceride level often goes with higher levels of total cholesterol and LDL, lower levels of HDL and increased risk of diabetes. LDLs are Low-Density-Lipoproteins and are the bad guys that when consumed can cause furring of your arteries causing your heart to work harder. HDLs stand for High Density-Lipoproteins and are the good guys that flow through your arteries and remove the LDLs.

Excessive alcohol intake — The risk of heart disease in people who drink moderate amounts of alcohol (an average of one drink for women per day) is lower than in nondrinkers. However, it’s not recommended that nondrinkers start using alcohol or increase the amount they drink! Excessive drinking and binge drinking can contribute to obesity, high triglycerides, cancer and other diseases, raise blood pressure, cause heart failure and lead to stroke. Pregnant women should not drink alcohol in any form.

Individual response to stress — Research has not yet defined the role stress plays in the development of heart disease. People respond differently to situations they find stressful. Unhealthy responses to stress, however, may lead to other risk behaviors like smoking and overeating.

What are the main tests for heart disease?

Diagnostic tests are usually needed to confirm the presence and to assess the severity of coronary heart disease. Often, more than one test is needed because different tests supply different information. Also, patients vary in their symptoms and may need more than one test to find out their heart condition. The primary tests used to diagnose heart disease are the electrocardiogram (ECG or EKG) and stress test (or treadmill test or exercise ECG). Different standards exist for reading the EKG in women as compared to men. Make sure your doctor knows this.

How can heart disease be treated?

Heart disease and its risk factors can be treated in three ways: by making heart healthy changes in your daily habits, by taking medication, and in some cases, by having a medical procedure. Lifestyle changes may include not smoking, following a heart healthy eating plan, maintaining a healthy weight, and becoming more physically active. When lifestyle changes are not enough to control heart disease and its risk factors, medications may be needed. Medications are often used to treat high blood cholesterol, high blood pressure or heart disease itself. Advanced heart disease may require procedures to open an artery and improve blood flow. These procedures are usually done to ease severe chest pain or to clear blockages in blood vessels.

What is the connection between hormone replacement therapy and heart disease?

Hormone replacement therapy (HRT) is a term for prescription hormone pills that are taken daily and can be used to relieve menopause symptoms. Estrogen pills have several important benefits. They can help you feel more comfortable as your body adjusts to lower estrogen levels by decreasing hot flashes, night sweats or vaginal dryness. HRT significantly reduces your long-term risk of heart disease, stroke and osteoporosis. Some studies show that estrogen may decrease the chance of developing or decrease the severity of Alzheimer's disease in women.

Estrogen therapy also has risks, including increased risk of breast cancer and cancer of the uterus. A woman and her doctor must decide whether the benefits of hormone therapy are worth the risks. If you are considering this treatment, you will need to consider your overall health and your personal and family history of heart disease, uterine and breast cancer, and osteoporosis.

More information about heart disease can be obtained by contacting:

National Heart, Lung and Blood Institute

U.S. Centers for Disease Control and Prevention