Cardiologist Shares 2 Heart Attack Risks In Women To Address Now

Cardiovascular disease remains the leading cause of death in the United States. It also happens to be the number one killer for women, responsible for 1 in 3 deaths each year. Yet awareness around heart attack risk lags. Only about 56 percent of U.S. women recognize heart disease as their greatest health threat, according to the CDC. The gap in heart attack risk perception can delay care, preventing women from seeking medical attention when symptoms of a heart attack or stroke arise.

Part of the problem is that heart disease doesn’t always look the same in women as it does in men. Plaque often spreads diffusely through women’s arteries instead of forming one large blockage. Rather than a single artery that can be opened with a stent or bypass surgery, multiple narrowed arteries restrict blood flow during exertion. The differences in both large and small vessels can produce symptoms that don’t follow the classic crushing chest pain, more commonly associated with men. Women also tend to have lower levels of early heart-damage blood markers, increasing the risk of missed or delayed diagnoses.

“Traditional angina is chest pressure or tightness that worsens with activity and improves with rest, usually associated with shortness of breath or fatigue,” says Tracy Patel, MD, FACC, RPVI, CCDS, a cardiologist at the Hartford HealthCare Heart & Vascular Institute.

“Women might not get this traditional chest discomfort as men do. This is why symptoms may be missed—traditional ‘chest pain’ may not be part of the story, and we women often brush off vague symptoms with our busy lives and long ‘to-do’ list.”

For these reasons, and especially during American Heart Month, understanding women’s heart attack risk factors and recognizing early warning signs is critical to protecting heart health.

Hypertension occurs when blood pressure measures at or above 130/80 mmHg. When blood pushes too forcefully against artery walls, the heart has to work harder to circulate it, increasing strain on the cardiovascular system over time. Often called the “silent killer,” high blood pressure usually develops without noticeable symptoms, so people typically don’t realize they have it until complications arise.

“Over the years, it literally places pressure on the blood vessels in our brains, kidneys, and hearts. It increases inflammation, damages our blood vessels, and causes plaque build-up that can lead to stroke, kidney damage, and heart attack,” Patel says.

Diabetes is a chronic metabolic condition marked by elevated glucose levels. It develops when the pancreas doesn’t produce enough insulin, preventing glucose from properly entering cells to be used for energy. As a result, sugar builds up in the bloodstream, increasing the risk of long-term complications such as heart disease, kidney damage, and nerve injury.

Over time, persistently high blood sugar also promotes inflammation and damages the lining of blood vessels, further raising cardiovascular risk, according to Patel.

For women in their 30s, 40s, and 50s, understanding personal risk factors, especially family history, is essential for protecting long-term heart health. Research has long found that chronic stress also has a major impact on cardiovascular outcomes.

Engaging in healthy lifestyle habits helps reduce the underlying drivers of heart disease. For instance, regular exercise strengthens the heart, improves circulation, and lowers blood pressure and cholesterol. Following a nutrient-dense diet helps decrease inflammation, stabilize blood sugar, and prevent plaque buildup in the arteries.

It’s also important to get enough sleep each night, aiming for at least seven hours, and incorporating stress-reducing practices such as yoga or meditation.

“Know your numbers: BP, HbA1c, weight, cholesterol—and discuss these with your primary care provider,” Patel suggests.

It’s important to know these numbers because each metric can help identify relevant risk factors, like hypertension and diabetes. Discussing with your primary care provider allows you to take proactive steps to protect long-term heart health.

Consider a Coronary Calcium Scan for specific assessment of plaque development within the heart. This is a noninvasive test that measures calcified plaque in the arteries to better assess heart disease risk beyond standard labs, especially in people at greater heart attack risk.