Heart Disease Affects Women of All Ages, Too

More than 60 million women are living with some form of heart disease in the U.S., but many more may be at risk and not know it.

"The biggest risk factor for heart disease is our age," said Nisha Parikh, M.D., M.P.H., a cardiovascular epidemiologist and an American Heart Association national volunteer expert cardiologist. "For women, we tend to see more heart attacks after they turn 65, but there's also a number of factors that can put you at risk even earlier."

Common cardiac risk factors include the following:

• High blood pressure
• High LDL cholesterol
• Smoking
• Diabetes (which itself is a cause of much female sexual dysfunction)
• High stress
• Obesity
• An unhealthy diet
• Physical inactivity
• Excess alcohol consumption

"There's also a number of reproductive and pregnancy-related risk factors that put women at risk for heart disease," added Parikh, who is also an associate professor of clinical medicine at the University of California, San Francisco.

Women who experienced difficulties during pregnancy, such as preeclampsia or gestational diabetes, and women diagnosed with polycystic ovary syndrome (PCOS) are at higher risk of developing heart disease.

Women who are bisexual could also be at an increased risk, according to one study. Women with depression, another study suggests, are at an even greater risk for cardiac illnesses, such as heart failure and coronary artery disease.

"We know that depression and anxiety and just stress, being under stress, are also risk factors for heart disease," Parikh said.

Heart disease doesn't wait to afflict only older women. As the obesity epidemic continues to weigh on the country, more young women are showing signs of heart disease.

"It's an unfortunate statistic," Parikh said. "We've been disappointed to see that rates of heart disease in younger women have been rising, where it's been a little more flat in older women."

Symptoms of a major cardiac event can be more subtle in women than in men, even if they're similar, which is why it's important for everyone to know the signs of cardiac distress before it's too late.

Signs of an impending heart attack in women can be similar to the classic heart attack symptoms men experience. These include the following:

• Nausea
• Numbness or tingling of the arm or fingers
• Chest pain radiating up to the jaw or down the left arm
• Increased perspiration

Still, a few less typical heart attack symptoms seem to be more frequent in women.

"Women are more likely than men to experience atypical symptoms, and some of those symptoms could be chest pain at rest or chest pain due to emotional distress," Parikh explained.

Right-sided chest pain, rather than the classic left-sided discomfort, is another atypical sign that a woman may be experiencing a heart attack.

Seek medical help if chest pain lasts a minute or more. Chest pain that lasts a matter of seconds is generally not considered a sign of a heart attack.

Parikh said her female patients are often unaware of how important heart health is, regardless of their age.

"[The most common misconception] is that heart health isn't important for them and they should be more worried about things like breast cancer or reproductive diseases as their primary potential health risks," she said. "But the truth is that heart disease and stroke are in the top three killers of women, and heart disease is number one."

Possibly the only good news surrounding heart disease is that it is largely preventable. A few lifestyle changes could turn the tables on a woman's risk of heart disease.

Parikh recommended patients keep their blood pressure and cholesterol in healthy ranges by maintaining a level of physical activity and a heart-healthy diet.

"It's so silent to have elevated cholesterol that somebody could have it for decades and not really know. And it's really over that time period that you slowly develop plaque in your arteries that can lead to heart disease and stroke," she said. "So it's really important to know early on what your cholesterol is."

Preventing or controlling diabetes, losing weight and quitting smoking are all ways she suggested women can improve their cardiac health.

Calorie counting is often the first suggestion for patients, said Susan MacDonald, M.D., a urologist and an assistant professor of surgery in the urology division at Penn State Health Milton S. Hershey Medical Center in Hershey, Pennsylvania. This approach can reduce blood pressure and heart disease, which are commonly linked to sexual dysfunction in men and women.

"The very act of tracking what you eat makes you eat differently, because you're cognizant, or as the kids say, present," MacDonald said.

Since stress is difficult to avoid in daily life, Parikh suggested patients try heart-healthy intentional breathing techniques, such as box breathing, to lower their blood pressure and decrease anxiety.

"The message I want to get across is just to know about those risk factors early, and then also just to empower yourself to take control of those risk factors because you can definitely do it," Parikh said. "You can definitely prevent heart disease and stroke—these are preventable diseases."

Given the importance of heart health to your overall and sexual well-being, make sure you discuss it with your doctor. If you don't have a doctor you see regularly, you should find one. Fortunately, telehealth takes the difficulty out of connecting with a physician who can answer your questions and evaluate your situation. Giddy telehealth is an easy-to-use online portal that provides access to hundreds of healthcare professionals whose expertise covers the full scope of medical care, and many offer same-day video appointments.