Ask An Expert About Heart Disease in Women

Posted on Feb 2, 2016

By Vindhya Hindnavis, M.D.

Sutter Health

plastic heart sitting on echocardiogram print outQ: Are symptoms of coronary artery disease the same in women and men?

A: Too often, women are unaware that coronary artery disease is a serious health risk and don’t get evaluated for heart disease, even though it could save their lives. Chest pain is a common symptom in men and women, but they often experience it differently.

Men tend to feel sharp chest pain during physical exertion, while in women, chest pain may occur with exertion or with emotional stress alone. Women also may experience unexplained fatigue or shortness of breath.

On average, women develop coronary artery disease 10 years later than men. This may be due to the protective role estrogen is thought to play in preventing heart disease. With menopause, estrogen levels drop, which may place women at greater risk for the disease.

Although men and women can have high LDL cholesterol, women naturally have higher levels of the “good” HDL (high-density lipoprotein) cholesterol than men, which helps remove the “bad” LDL cholesterol from arteries. So, low HDL levels in women are a serious risk factor for heart disease.

Vindhya Hindnavis M.D.

Vindhya Hindnavis M.D.

African-American and Latina/Hispanic women have a greater prevalence of certain risk factors.

The Basics of Coronary Artery Disease

This type of heart disease occurs when fat and cholesterol, known as plaque, build up in the vessels that supply blood to the heart. The plaque narrows the blood vessels, which reduces the flow of blood. Most heart attacks occur when a blood clot forms on the plaque and cuts off the blood supply to the heart.

What’s Your Risk?

Common risk factors include:

  • Smoking
  • High blood pressure
  • High LDL cholesterol
  • Low HDL cholesterol 
  • Diabetes
  • Lack of exercise

Stress Test Often Used to Diagnose

A cardiac stress test is often used to diagnose coronary artery disease by monitoring the heart’s electrical activity and pumping performance. However, even when their hearts are healthy, women are more likely than men to show irregularities during cardiac stress tests. This can create a false positive for heart disease, so doctors also use an imaging test to confirm the results of stress tests in women.

If you are diagnosed with the disease, many effective medications and interventions are equally successful in men and women.

How to Keep Your Heart Healthy

Prevent a heart attack by catching heart disease before symptoms begin. Have your cholesterol and blood pressure levels checked regularly beginning at age 45. You can also reduce your risk for coronary artery disease by

  • Maintain a healthy weight
  • Eat a diet low in fat, salt and simple sugars
  • Exercise regularly (at least 30 minutes, five times a week)
  • Quit smoking
  • Maintain optimal cholesterol and blood pressure values

February is American Heart Month. Take the opportunity to talk with your doctor about your heart health. Find exceptional cardiovascular care in the East Bay.



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