Understanding Women’s Heart Health at Every Stage

Each phase of a woman’s life from pregnancy to menopause brings changes that can influence heart health. Recognizing these shifts early can significantly reduce your risk for heart disease.

Neelu Vallurupalli, M.D., a cardiovascular disease specialist with Sutter, points out how dangerous heart disease is for women: “When you combine the deaths from the three main cancers in women — lung cancer, breast cancer and colon cancer — heart disease is still the No. 1 killer.”  

Here’s what to know about women’s heart health. 

Pregnancy and Heart Health 

Health changes that sometimes develop during pregnancy can affect the long-term health of your heart: 

• Pregnancy-induced hypertension: Having high blood pressure during pregnancy can increase your risk of heart disease later in life.
• Gestational diabetes: Developing diabetes when you're pregnant increases your risk of diabetes later in life, and diabetes, in turn, is a risk factor for heart disease. 

Menopause and Heart Health 

The hormonal changes that happen during menopause can affect the risk of heart disease in women.  

“Your weight could go up, your blood pressure could go up, your cholesterol could go up, and you could develop glucose intolerance, meaning you’re more sensitive to carbs, causing  insulin resistance,” Vallurupalli says.

Many women have trouble sleeping well as they transition to menopause, and that also affects cardiovascular health by raising stress hormones.

Women at this life stage may have trouble finding time to take care of themselves, especially if they’re caring for aging parents, their kids are growing up and they’re at the peak of their careers.

After menopause, heart disease risk factors for women are the same as for men. 

Other Issues That Affect Women’s Heart Health

• Autoimmune disease: Conditions like lupus and rheumatoid arthritis may raise your risk of heart disease and are much more common in women than in men.
• Stress-induced cardiomyopathy: This condition where the heart’s left ventricle becomes weak after severe stress is more common in women. That could be because women are often the caregivers for their entire family, including their parents, children and husband, and are often working full-time as well.
• Research discrepancies: Most treatment trials were performed mainly on men. “When these medications come out, we might see a completely different set of side effects. And the dosage might be too much for women, because it was predominantly tested in the male population,” Vallurupalli says.
• Differences in symptoms: Female heart attack symptoms can be different and more subtle than men’s — chest discomfort with exertion, fatigue and shortness of breath. “Women need to be vigilant,” Vallurupalli says. 

Preventing Heart Disease in Women

“I tell people every day that heart disease is preventable, and we can be proactive,” Vallurupalli says. “There’s a huge difference between the genders and doing the same thing that we do for men will not work for women.”

She recommends:

• Following up with your doctor if a blood pressure screening at your dentist, optometrist or in another location shows concerns
• Knowing your family history and sharing it with your healthcare provider
• Managing your weight
• Seeing your doctor to get your blood pressure checked, since high blood pressure usually doesn’t cause any noticeable symptom
• Sharing your personal medical history with your provider. For example, if you’re an older woman, your doctor may not know about high blood pressure or diabetes you had when you were pregnant.
• Staying up to date on your bloodwork, so your provider can spot issues before you notice any symptoms
• Talking to your provider or checking trusted sources like the American Heart Association for recommendations about diet, exercise and other lifestyle changes