Heart and Vascular

Heart disease in women: Uncovering the silent killer

Three women posing for a photo with heart shaped prop


By Carol Gemayel-Barra, MD


Heart disease has long been considered a men's health issue, but it's a threat that affects women equally. In fact, heart disease is the leading cause of death for women in the U.S., surpassing breast cancer.


Research has historically focused on men, leading to a significant gender gap in our understanding of heart disease. Women often present with different symptoms than men and may not receive timely diagnosis and treatment. This disparity has profound consequences as untreated heart disease can progress and lead to long term adverse consequences in women.


Understanding the unique aspects of heart disease in women, the risk factors, symptoms and prevention will go a long way toward saving lives and improving outcomes.


Heart disease risk factors for women

Several factors contribute to the development of heart disease in women including:

  • Postmenopausal state: Estrogen, a hormone that provides some protection against heart disease, decreases during menopause.
    This change can increase a woman's risk of developing heart disease.
  • Family history: If a close family member has had heart disease, especially at an early age, the risk increases.
  • Age: The risk of heart disease increases with age. Women over 55 are more vulnerable.
  • Cholesterol: Elevated cholesterol levels, specifically LDL particles, can lead to arterial plaque buildup.
  • High blood pressure: Elevated blood pressure is a major risk factor for heart disease in both genders, but women with high blood pressure are at a higher risk than men.
  • Diabetes: Women with diabetes are more likely to develop heart disease compared to men with diabetes.
  • Pregnancy: Women who develop preeclampsia, eclampsia and gestational diabetes should seek cardiology referral so that those risk factors can be carefully monitored.
  • Obesity: Being overweight or obese is a risk factor for heart disease. Women are more likely than men to be obese.
  • Autoimmune disorders: Women with autoimmune disorders including systemic lupus or rheumatoid arthritis should be considered at risk and screened for cardiovascular disease.
  • Lifestyle choices: Unhealthy eating habits, lack of physical activity, smoking and excessive stress can all contribute to heart disease risk.

Check out this Nuvance Health physician video on heart disease risk factors in women.

Heart disease symptoms in women

Women often experience different symptoms of heart disease than men. While chest pain is a common symptom for both genders, women are more likely to have:

  • Shortness of breath
  • Indigestion and/or heartburn
  • Upper back and/or jaw pain
  • Fatigue

These atypical symptoms can lead to misdiagnosis or delayed diagnosis, potentially resulting in more severe outcomes. Therefore, it is crucial women recognize these signs and seek medical attention promptly.


Check out this patient story on surviving a heart attack and how symptoms differ in women.


Heart disease prevention tips'

Preventing heart disease in women involves both lifestyle changes and medical interventions:

  • Healthy lifestyle: Adopting a heart-healthy lifestyle, including a balanced diet, regular exercise, not smoking and stress management, can significantly reduce the risk of heart disease.
  • Medications: Some women may need medication to manage high blood pressure, high cholesterol or diabetes. Know your numbers, target goals and work to achieve them.
  • Hormone therapy: Hormone replacement therapy (HRT) during menopause can be considered, but it is not suitable for all women and should be discussed with a healthcare provider.
  • Regular check-ups: Routine check-ups are essential for early detection and management of risk factors.

Check out this patient and physician roundtable discussion on women and heart disease.


Screenings for heart disease

At the Nuvance Health Medical Practice cardiology office in New Milford, there are several screenings that can be ordered and/or performed to assess your cardiovascular health. These may include:

  • Electrocardiogram (EKG) checks your heart’s electrical system and rhythm.
  • Stress test evaluates how your heart responds to exercise.
  • Coronary calcium CT scan provides early detection of cholesterol deposits in the coronary arteries.

Learn more about cardiovascular imaging and testing at Nuvance Health.


Heart disease is a silent killer that affects women as much as men, if not more. The key to reducing the prevalence and impact of heart disease in women lies in awareness, education and early intervention. Women should be proactive in understanding their heart health and physicians must be attune to their circumstances to ensure timely diagnosis and effective management. Together, we can combat this leading cause of death among women and pave the way for heart healthy lives.


Learn more about the Nuvance Health Heart and Vascular Institute.


Dr. Gemayel-Barra is the director of the women’s cardiac and heart failure programs at The Danbury Hospital, part of Nuvance Health.