While most women's risk factors, signs, and symptoms are the same as for men, there are some unique aspects to women’s heart health.
Estrogen provides a protective effect on women’s cardiovascular health during the premenopausal years; however, estrogen’s protective effect can change, depending on a variety of conditions. For example, in a small proportion of women, oral contraceptives can increase the risk of high blood pressure and blood clots. The risk is greater if you smoke, already have high blood pressure (especially if you are over age 35), have other risk factors for heart disease or stroke, or already have a blood clotting problem.
When women reach menopause (in the early fifties), their risk of heart disease increases. Researchers suspect this may be related to a drop in production of the hormone estrogen. A menopausal woman may experience an increase in LDL or “bad” cholesterol and triglyceride levels and a decrease in HDL or “good” cholesterol. She may show a tendency toward higher blood pressure. Reduced estrogen levels may also increase body fat above the waist, have harmful effects on the way blood clots, and affect the way the body handles sugar, a precursor condition to diabetes.
Until recently, hormone replacement therapy was recommended to help reduce this risk for menopausal women. Recent studies have shown that taking certain types of hormones (estrogen with progestin) can actually increase the risk of heart attack, stroke, blood clots, and breast cancer for some women. As a result, hormone replacement therapy is no longer recommended to prevent heart disease.
A woman's risk for developing heart disease increases if she has any blood relatives who were diagnosed with heart disease before the age of 55.
Women with low levels of education and income face a higher risk of heart disease, possibly because they don't have the knowledge or the resources to follow healthy behaviors that prevent heart disease.
While women of all races are at risk of developing heart disease, the risk is higher for Black and South Asian women.
Premenopausal women with diabetes have similar risk to men of the same age because diabetes cancels out the protective effects of estrogen.