How Women Experience Heart Disease Differently

MISSION, Kan., May 5, 2025 /PRNewswire/ -- (Family Features) Most people think of heart attacks as debilitating pain in the chest. However, that's not always the case, especially for women, and missing the signs can be a matter of life and death.

Although heart disease is the leading cause of death among American women, according to the American Heart Association, symptoms are often overlooked or explained away as less worrisome conditions.

"Men and women experience many aspects of life differently, and heart disease is no exception," said LeAnne Bloedon, MS, RD, vice president of clinical development, Esperion Therapeutics. "Symptoms of a heart attack aren't as obvious as many women think, and failing to recognize the danger and get help can have catastrophic results."

One heart disease risk factor, for example, is high LDL cholesterol. Often referred to as a "silent killer," it doesn't always present noticeable symptoms. In fact, data suggests women with high LDL cholesterol are not diagnosed or treated as early or aggressively as men, which can put women at an increased risk for cardiovascular events. Understanding how men's and women's risk and symptoms differ may help identify and treat a serious heart health problem before it causes lasting damage.

Anatomy Differences

Some differences between men and women are present in the body's internal systems, including the cardiovascular system. Women generally have smaller hearts and narrower blood vessels.

This can affect heart health in numerous ways, including less efficient stress responses and greater risk of widespread plaque buildup, especially in smaller vessels, called microvasculature, which can pose treatment challenges.

Cholesterol Buildup

Hormones influence aspects of the body's function, including cholesterol levels. Estrogen, a female sex hormone, raises HDL (good) cholesterol levels. This may be why women tend to have more HDL cholesterol and lower LDL (bad) cholesterol than men, especially before they reach menopause, though inherited high cholesterol can affect women of all ages.

"It's critical to raise awareness about the importance of measuring LDL cholesterol, diagnosing high cholesterol and treating elevated LDL cholesterol per guidelines and individual patient needs," Bloedon said.

Risk Factors

While there are shared risk factors for heart disease among men and women (such as obesity, high blood pressure and diabetes), some risk factors disproportionately affect women. For example, uncontrolled cholesterol in women, particularly after menopause, can increase the risk of heart disease and stroke.

Care and Treatment

"While you may not be able to fully prevent heart disease, you can understand the risks and take proactive steps," Bloedon said. "Commit to a healthy, smoke-free lifestyle. Exercise regularly and eat a well-balanced diet with limits on processed foods, sugar, sodium and alcohol. Take any medications as directed by your health care provider."

Statins, which reduce the production of cholesterol in the liver and lower cholesterol levels in the bloodstream, are the medications most often prescribed to help manage high LDL cholesterol. While generally well-tolerated, statin intolerance (the inability to take a statin at any dose or the recommended dose) does occur in some patients and is more common in women.

Talk with your doctor about other steps you can take to manage elevated LDL cholesterol levels and learn more about women's heart health at goredforwomen.org.

Symptoms of Heart Attacks in Women

Women's experiences with heart disease may be quite different from men.

For example, according to the Heart Disease Foundation, women are likely to be older when they experience a heart attack. They may also attribute symptoms to other conditions, such as diabetes or arthritis.

Further complicating matters, several diseases mimic heart attacks so getting to the root of the problem can be tricky. Women are more apt than men to experience a coronary spasm, coronary dissection or broken heart syndrome.

What to Watch For:

• Like men, women experiencing a heart attack may notice prolonged or reoccurring chest pain or pressure.
• In women, that pain may extend to the arms, back, neck, jaw and stomach.
• Some women experience shortness of breath with no chest pain at all.
• Other symptoms women are more likely to report can be easily mistaken for other conditions. Some of these signs include unexplained fatigue, disruptions to normal sleep patterns, lightheadedness, nausea and cold sweats.

Michael French
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editors.familyfeatures.com

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