Heart and Vascular

Women vs. Men: How is Heart Health Different?

Feb 28 2024

Heart health is often overlooked by women, yet heart disease is a leading cause of death for women worldwide.

There remains a significant gap in awareness and understanding of cardiovascular health among women. So, to raise awareness of heart health in women, we asked Gerri Hempfling, nurse practitioner with Mercy Health – St. Rita’s Cardiology, to answer some insightful questions to further explored the intricacies of heart health tailored specifically to women.

I often encounter women who were shocked to find out that they had heart disease. In fact, the first they knew was at the time they had their heart attack,” Gerri shares. “Many had one or more vague symptoms and dismissed them. Most women do not pay as much attention to their own health as they should because they are busy with multiple things on their plate. They also often minimize how the risks associated with being overweight, having diabetes or smoking have on their heart health.”

Q: Do women and men experience different heart attack symptoms?

A: Yes! Men will more often present with the classic crushing, midsternal chest pain that is recognized as typical for a heart attack. It is often associated with radiation of the pain to the left arm and sweating. 

Symptoms in women are more atypical in that the pain is more often noted in the back, between the shoulder blades, the upper abdomen, neck, throat or jaw. It may present just as discomfort in the arms or as more vague symptoms, such as ongoing fatigue out of proportion to normal lifestyle demands. Other symptoms include dizziness, palpitations, shortness of breath and nausea and/or vomiting. 

With many of the symptoms being vague, they are often ignored or just considered normal due to a busy lifestyle or stress. Sometimes women attribute their symptoms to anxiety or their emotions and dismiss the symptoms as anything possibly serious. The important thing is to pay attention when the symptoms keep occurring or come on and don’t subside. They then need to be further evaluated.

So, if symptoms occur and don’t relent, the best action is to call 911 so treatment can take place en route to the hospital and the appropriate personnel be alerted to avoid delay in treating a heart attack upon arrival to the facility.

Q: What should women know about heart health during pregnancy and the postpartum period?

A: Heart health in pregnancy begins with having heart-healthy lifestyle practices in place prior to pregnancy, then continuing those practices throughout the pregnancy helps to limit complications. High blood pressure can develop during pregnancy whether one has a history of high blood pressure or not. In addition, gestational diabetes can lead to more serious concerns regarding pre-eclampsia and eclampsia.

If someone has underlying heart disease or had a congenital heart condition at birth, it is important to discuss these factors with their doctor prior to becoming pregnant. In doing so, potential complications can be closely watched for, further evaluated and treated to promote positive health outcomes for both mom and baby.

During pregnancy, a woman’s body adapts with several cardiovascular changes. As pregnancy advances, many will experience swelling in the feet, ankles and hands. Some shortness of breath with more physical activity at the end of the pregnancy due to the size of the fetus is also common. Both the swelling and shortness of breath should resolve shortly after delivery. If swelling and shortness of breath persist, especially if noting a cough, difficulty breathing when lying down or waking during the night due to feeling like unable to get one’s breath, an evaluation is warranted. These symptoms may represent a condition known as postpartum cardiomyopathy; meaning the pumping function of the heart is lower than normal. 

Postpartum cardiomyopathy may present during the last month of the pregnancy through approximately the first five months after delivery. This is a form of heart failure and can be life-threatening. But it is treatable, and recovery is possible if promptly diagnosed and treated. Recovery may be limited and may take up to two to three years to fully recover. 

Q: How does menopause impact heart health in women?

A: Estrogen protects pre-menopausal women from heart disease. Therefore, post-menopause, the risk of heart disease in women and men becomes almost equal. Please note that hormone replacement therapy has not shown to be protective from heart disease in women. If anything, it is harmful. So, if hormone replacement therapy is needed to control menopause-associated symptoms, its use should be for the briefest time possible.

Q: How can women incorporate heart-healthy habits into their lives?

A: Metabolic syndrome encompasses many of the risk factors for heart disease that pose the greatest risk of contributing to heart disease in women. Metabolic syndrome is comprised of increased waist circumference, elevated triglycerides, elevated blood pressure, elevated glucose levels and low HDL cholesterol levels.

Diet and nutrition are very important in controlling many of the elements of metabolic syndrome. Incorporating fish, nuts, fruits, vegetables and legumes are healthy choices. Also, watching portion sizes, avoiding sugar-laden foods and foods high in sodium can make a big difference. Limiting alcohol and caffeine is also important.  

  1. A helpful philosophy in improving your diet is to try to eat healthy for more meals of the day and more meals of the week than not. We are all human and need a treat once in a while, just not all the time.
  2. Another important step in prevention of heart disease is regular exercise. Current guidelines recommend 150 minutes of moderate-intensity activities a week or 75 minutes of vigorous activity a week. Breaking it into a couple short periods each day is also beneficial and may be less overwhelming. Strategies such as parking a little farther from the door, using the stairs instead of the elevator or adding a trip around the kitchen table as you move from room to room can all add up. 
  3. Many women suffer from musculo-skeletal disorders that limit their ability to perform vigorous, joint-impacting activities. The internet is a great place to find exercises that can be done sitting down or with little or no impact.
  4. Discuss these options with your primary care provider or cardiologist if you have concerns before beginning. The key with beginning any exercise program is to start slow and build from there. The goal is to develop a regular pattern of exercise that can be sustained. 
  5. High blood pressure control is extremely important in not only preventing heart disease but also stroke prevention. The diagnosis of high blood pressure needs to be taken seriously as it can lead to profound damage to the heart muscle itself if left untreated. Avoiding sodium and compliance with ordered medications are key. Adequate water intake also plays an important role as it contributes to optimal kidney function and the kidneys play a vital part in blood pressure control. 
  6. Glucose control goes right along with this as uncontrolled blood sugar levels contribute to metabolic syndrome and high triglyceride levels. The diagnosis of diabetes carries a higher risk of heart disease in women than men. Tight glucose control and carefully managed diabetes are extremely important in the prevention of cardiovascular disease.
  7. Tobacco abuse is also a stronger contributor of heart disease in women than men. Smoking triples the risk of having a heart attack in women. Smoking while on some birth control medications can be a deadly combination as it promotes the formation of blood clots.
  8. Stress and depression also contribute to heart disease more often in women than in men. Developing healthy stress-relieving behaviors and following prescribed treatments for depression help lower the risk.

Whether it’s understanding the atypical symptoms of a heart attack for females, navigating heart health during pregnancy and postpartum or managing lifestyle factors, the journey towards healthier heart health for women begins with knowledge and action.

Learn about the heart and vascular care services we provide at Mercy Health.

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