Roxana Mehran, MD
Heart disease is the leading cause of death for women in the United States. Unfortunately, awareness about this fact remains low, with many believing breast cancer is the leading cause of death for women. Underestimation of heart disease risk in women has been an issue not only among women themselves but also among the health care community. However, positive change has occurred, with numerous campaigns and initiatives to increase women’s heart health awareness over recent years.
In this Q&A, Roxana Mehran, MD, Director of Interventional Cardiovascular Research and Clinical Trials at the Icahn School of Medicine at Mount Sinai and a world leader in women’s cardiovascular health, explains why it is important for women to know more about heart disease and to take control over their health.
What are the risk factors for heart disease?
Important and well-known risk factors for heart disease in women and men include high blood pressure, high cholesterol, and diabetes. However, there is increasing evidence about risk factors that exclusively affect women. For example, certain conditions related to pregnancy have been associated with the development of heart disease later on in life. These include high blood pressure or elevated blood sugar during pregnancy and delivery of a smaller baby than usual for the number of weeks of pregnancy. Women are also more likely than men to be affected by risk factors that are still underrecognized, such as depression, abuse, and intimate partner violence. And lastly, women are overrepresented among those living in less wealthy areas with less access to healthy food, exercise, and education, resulting in increased risk for heart disease.
Are there other differences in heart disease between women and men?
Yes. The underlying mechanisms of certain aspects of heart disease differ between women and men. Unfortunately, most of our study data on heart disease are derived from male populations. Therefore, diagnosis and treatment of heart disease are mainly based on data from male patients. Luckily, the differences in heart disease between women and men have gained the attention of researchers and become the focus of an increasing number of research studies. Although scientific evidence on the optimal diagnosis and treatment of heart disease in women is increasing, we still have a lot to learn about why and how heart disease develops and presents differently in women and men.
What are the signs of heart disease in women?
When there is insufficient blood supply to the heart muscle due to a blocked artery or other reasons, the most common symptom will be chest pain. However, the limited blood flow to the heart muscle can also cause other symptoms, such as extreme fatigue, nausea, and pain in the jaw, neck, and shoulder. These can be signs of a heart attack and are more commonly observed in women compared to men.
Is heart disease preventable?
The good news is that healthy lifestyle changes can prevent 80 percent of premature heart attacks and strokes. A healthy diet, regular exercise, and not using tobacco products (including vaping) are key to lowering your heart disease risk. In addition, screening and treatment of risk factors such as the ones mentioned above are essential to keep your heart healthy. Therefore, at Mount Sinai, we provide women with a comprehensive assessment of their heart health and heart disease risk. We help with initiating the important steps to a healthy lifestyle and recognizing and addressing heart disease risk factors, including those unique to women.
What is your advice to women about heart disease?
It is never too early and never too late to think about heart disease and learn how to prevent what is preventable. We are here to help when you start taking control over your heart health.