By Cyra-Lea Drummond, BSN, RN 

 Fact checked by Nick Blackmer

Ponomariova_Maria / Getty Images

Key Takeaways

• Heart disease is the leading cause of death for women, claiming more lives each year than all forms of cancer combined.

• Knowing your risk factors for cardiovascular disease and discussing them with your healthcare provider are two proactive steps you can take to protect your heart.

Experts are calling for an increased focus on women's cardiovascular wellness in an effort to prevent the poor outcomes women often face when they develop heart disease. While the call-to-action might seem simple enough, it's easier said than done for many.

On May 16, 17 experts from 11 countries authored the first-ever global report on cardiovascular disease (CVD) in women. The commission outlines 10 new recommendations to address women's heart health including educating healthcare providers and patients on early detection and prioritizing sex-specific research on heart disease in women.1

But whether it's juggling responsibilities at work and at home, women may find it especially difficult to make their health a priority. The good news is, there are some preventive measures that you can take to prevent heart disease.

Why Women Experience High Rates of Heart Disease

“More women have been dying of heart disease than men since 1984," Suzanne Steinbaum, MD, a holistic cardiologist, author, and volunteer medical expert for Go Red For Women, tells Verywell. "It’s not that it’s new, it’s that we’re finally talking about it. We know that the risk of heart attack and stroke is increasing in women under 55, and for women in that group the outcomes are worse.”

Nicole Harkin, MD, FACC, a preventive cardiologist and the founder of Whole Heart Cardiology, tells Verywell that “heart disease in women has been underrecognized for some period of time,” and that "one in three women will die of heart disease, which is more than all cancers combined. It takes away many decades of our life.”

Harkin cites a variety of reasons for the high rates of cardiac-related deaths in women.

“Historically it was considered that heart disease was a man’s disease," she says. "Women tend to be diagnosed with heart disease later in life than men, and women are more likely to present later in the course of having a heart attack.”

Women often get diagnosed with a heart attack later than men because they do not necessarily present the same signs or symptoms.

“While women most commonly present with chest pain when they’re having a heart attack, they also can have lesser-known signs and symptoms, such as anxiety, shortness of air, nausea, vomiting, atypical pain location," Harkin says. "They are also more likely to have symptoms brought on by stress."

What's more, healthcare providers may not spot these more subtle indications of a heart attack. “We do have some research to show that women are underrecognized as having a heart attack by the medical community, as well," Harkin says. "And once we’re diagnosed, we’re more likely to get undertreated."

Harkin adds that even when women are diagnosed, they tend to be prescribed fewer medications and less aggressive treatments for heart disease than men.

Many Women Put Their Health on the Back Burner

To address the life stressors that many women are enduring, Harkin advocates for a “family first approach" that helps women care for themselves and their families. The approach also teaches kids healthy habits.

“Heart health begins early," Harkin says. "Beginning to engage in heart health prevention as a family is an effective way that women can work on their own heart health as well as doing that for their children.” She suggests taking walks or hikes together as a family and including children in meal planning and preparation.

The Added Stress of COVID

During the COVID-19 pandemic, women have endured added pressure, which comes not only with short-term, but potentially long-term, physical and mental health consequences. Prolonged stress can increase the risk factors for heart disease. Plus, more women than men have been avoiding preventive and routine healthcare during the pandemic.

Women have to put themselves first on the list, and usually, they don’t. They often prioritize themselves last.

— SUZANNE STEINBAUM, MD

“People overate, they became sedentary, and they had debilitating fear, but specifically for women who were juggling work, full-tines teachers at home, caretaking, it’s been such a heavy load,” Steinbaum says. “I’m watching people being sicker and sicker.”

In her practice, Steinbaum says that she has seen the health effects of the pandemic in patients who did not actually get sick with the virus but have experienced intense stress. That's not all that surprising, since chronic stress has been shown to raise cholesterol levels and blood pressure.

Weight gain during the pandemic could be another factor because excess body weight can also increase lipid levels and contribute to high blood pressure.

Making time for health can be especially challenging for women, who often have to balance caring for themselves, their work, and their families. “Women have to put themselves first on the list, and usually they don’t. They often prioritize themselves last,” Steinbaum says.

What This Means For You

There are certain lifestyle changes you can make to improve your heart health like exercising daily, reducing stress, and making changes to your diet. Experts recommend starting a conversation with a healthcare provider about your current risk levels for CVD and how you can implement some of these lifestyle changes.

Know Your Numbers

Steinbaum says that the first and most important step that women can take is to “know your numbers"—that is, your most relevant risk factors for heart disease. Important metrics to know include:

• Your total cholesterol, HDL, LDL, and triglyceride levels

• Your blood pressure

• Your blood sugar (especially if you are diabetic)

• Your body mass index (BMI)

• Any family history of heart disease, high blood pressure, or stroke

Your risk of heart disease also increases if you have other medical conditions, including:

• A personal history of pregnancy-related complications (such as gestational diabetes, pregnancy-induced high blood pressure, and recurrent miscarriages)

• Early menopause (before the age of 40)

• Hormonal factors (such as polycystic ovary syndrome or taking hormone replacement therapy)

• Autoimmune diseases

“It’s really about empowering yourself with education, knowing what your risk factors are, and doing something about them,” Steinbaum says. “Communicating with your healthcare provider is essential to understanding if you need to make lifestyle modifications. And for some women, they are going to need medication.”

How to Improve Your Heart Health

“Women need to be aware that they need to be their own advocates," Harkin says. "While there are some things that are out of our control, there are still plenty of things we can do to control our risk of heart disease."

Making lifestyle changes and taking medications prescribed by your doctor, if necessary, can lower your risk of developing cardiovascular disease.2

Exercise Daily

Being physically active offers many health benefits. Your cardiovascular system gets many of them when you give it a good workout, whether it's taking a walk or bike ride, going for a swim, or hitting the gym.

“Exercise is the best medication for everyone,” Steinbaum says. “We gotta get up and move a little bit more.”

The Centers for Disease Control and Prevention (CDC) recommends that most adults participate in moderate-intensity exercise for 30 minutes a day, five days a week (a total of 150 minutes a week).3

Make Changes to Your Diet

Research has long found a link between your heart's health and what you eat and drink. Making a few simple changes to your diet might help lower your risk of heart disease and can also help you manage or prevent conditions related to your cardiovascular health, like high blood pressure.

Some changes include:

• Limit processed foods, added sugars, and excess sodium from salt.

• Choose high-fiber complex carbohydrates, such as whole grains, quinoa, brown rice, beans, and legumes. Limit processed carbohydrates like prepacked baked goods and white bread.

• Fruits and vegetables are another nutrient-loaded way to get fiber, which has been shown to help lower your cholesterol levels.

• Unsaturated fats (which mostly come from plant sources such as avocados, nuts, seeds, and olive oil) are a healthier choice for your heart than saturated fats (which are primarily found in meat and dairy).

Quit Smoking and Avoid Substances

Smoking and using tobacco products have many detrimental effects on your health—especially for women. If you're ready to quit, talk to your doctor about resources.

 Preventing Heart Disease

Other substances also have short- and long-term health consequences, and many can directly damage your heart. If you need help addressing your substance use, ask your medical or mental healthcare provider about where to go for support.

If you drink alcohol occasionally, the CDC recommends women limit their consumption to 1 alcoholic drink or less per day.4

Reduce Your Stress

Brewing a cup of tea, taking a walk, calling a friend, and gratitude journaling are all strategies that Harkin recommends to her patients when they need to reduce their stress levels. These changes can also help improve your sleep—another important component of protecting your heart.

"Sleep and stress reduction are underrecognized and emerging risk factors for heart disease," Harkin says. "I work with my patients on incorporating mindfulness in their daily lives." She suggests trying a meditation app like Headspace, Calm, or 10% Happier.

Talk to Your Doctor About Your Medications

You might still have high blood pressure, cholesterol, triglycerides, or blood sugar even if you are getting regular exercise and making heart-healthy changes to your diet and lifestyle. In this case, your doctor will want to talk to you about taking medications to help keep these levels in check.

If your doctor prescribes you a medication, it's very important that you take it exactly as they prescribe.

“About 50% of patients will stop their statin within the first year of starting it, and not even talk to their doctor about it," Steinbaum says. She urges patients to speak with their doctors about their concerns before discontinuing a prescribed medication—especially statins, which are prescribed to help lower your risk of heart disease.

If you feel like the medication that you're on is not working well for you, there might be another option. "If someone is on medication, and it is not working for them, they need to communicate with their doctor," Steinabum says. "If they don’t feel great on one, they can be put on another.”

While you can expand your knowledge on your own, Steinbaum warns against making any health decisions based solely on online research. “There’s a lot of bad information out there," Steinabum says. "If you’re going to inform yourself, go to a source that gives you good information.”

Instead, she encourages people to talk to a doctor about their concerns and come up with a way to tackle them together.

4 Sources

Vogel B, Acevedo M, Appelman Y et al. The Lancet women and cardiovascular disease Commission: reducing the global burden by 2030. The Lancet. 2021. doi:10.1016/s0140-6736(21)00684-x

American Heart Association (AHA). CDC Prevention Programs.

Centers for Disease Control and Prevention (CDC). How much physical activity do adults need?.

Centers for Disease Control and Prevention (CDC). Dietary Guidelines for Alcohol.

By Cyra-Lea Drummond, BSN, RN
 Cyra-Lea, BSN, RN, is a writer and nurse specializing in heart health and cardiac care.