Heart disease remains the top cause of death for women in the United States.
About 1 in every 5 female deaths are linked to heart disease.
A recent national survey from the American Heart Association found that despite the risk, many women are unaware of the signs of heart attack and stroke or the risk heart disease poses to women.

Heart disease is the leading cause of death of women in the United States. But if you ask most American women, a surprisingly low number would not know that fact, according to new research.

According to the Centers for Disease Control and Prevention (CDC)Trusted Source, about 1 in every 5 female deaths are linked to heart disease.

A national survey published this week in the Circulation journal from the American Heart Association found that despite the risk, many women are unaware of the signs of heart attack and stroke or the risk heart disease poses.

The survey found that from 2009 to 2019, awareness of heart disease as the leading cause of death for women decreased from 65 percent to 44 percent.

Awareness also declined among the following areas: warning signs of a heart attack and stroke, first action to take when someone is having a heart attack or stroke, and heart disease and stroke risk factors.
What women should know

The decline was observed in women of all ages, except those greater than 65 years old, and in all racial and ethnic groups.

“It is disappointing to hear that younger women were less likely in 2019 to lead a heart-healthy lifestyle than in 2009,” said Dr. Eugenia Gianos, director of Women’s Heart Health at Lenox Hill Hospital in New York. “This, coupled with lack of awareness about heart disease, may explain the rise in heart disease mortality we are seeing in younger women.”

However, lack of awareness was greatest among women less than 34 years old and in non-Hispanic Black and Hispanic groups. According to the CDC, Black women are about 60 percent more likely than white women to have heart attacks, “primarily because of socioeconomic factors such as poor insurance coverage, lack of quality care, and insufficient prenatal counseling.”

When women have a heart attack, they may have different symptoms compared to a man. While chest discomfort is common, they may experience other symptoms that are less associated with heart attacks including dizziness, shortness of breath, or nausea.

Other symptoms can include:

pain or discomfort in the back, jaw, stomach or both arms
breaking out into a cold sweat
shortness of breath with or without chest pain
vomiting
chest pain

A matter of education

The findings of the survey show that the greatest lack of awareness is in women under ages 34, and in non-Hispanic Black and Hispanic women.

These findings highlight, among other things, the disparities in education among socioeconomic communities.

The most recent report said that, “Women at high CVD (cardiovascular disease) risk (heart disease or stroke) had higher awareness than women without these conditions in 2009, but this was not seen in 2019.”

The report also found that people with diabetes were not more likely to be aware of cardiac warning signs even though they would be more at risk for cardiac event.

Additionally they found that women with hypertension had 30 percent lower awareness of cardiac warning signs compared to women without hypertension.

“Although disparities exist in the awareness of heart disease as the leading cause of death in women, the real lesson from this study is that there is a universal deficiency in education that must be urgently addressed,” said Gianos. “The results of this study bring to light the urgent need for increased research funding dedicated to the education, prevention, and treatment of heart disease in women.”

“It’s not just about putting the messages out on social media,” added Dr. Nieca Goldberg, cardiologist and medical director of the Women’s Heart Program at NYU Langone Health. “It has to be something that connects with people who are potentially at risk. We really need to be very diverse in making sure women of all backgrounds get evaluated.”

“It’s disappointing,” she said. “I’m still continuing to do this work. We’re not moving the needle. I think a good message is, ‘You’re never too young to learn about heart disease risks and to start preventing them.'”
Causes of heart disease in women

Some of the risk factors for heart disease among women include:

high blood pressure
high cholesterol
diabetes
cigarette smoking
sedentary lifestyle
obesity
family history

But even for women who do not have these risk factors, there are still measures to be taken to ensure that they are leading a heart-healthy lifestyle.

“We need the medical community to get together to show women it’s not just about those risk factors, but other factors to evaluate,” said Goldberg. “Certain autoimmune diseases, such as rheumatoid arthritis, put women at increased risk for heart attack. [The same is true of] women with pregnancy-related conditions. We need doctors of many specialties, not just cardiologists, to work together to reach out to women of all ages about their potential risk factors.”

Fortunately there are proactive measures that all women can take every single day in order to help reduce their risk of heart disease. Some of these measures include:

Eat a healthy diet, rich in fruits, vegetables, and whole grains — and low in saturated fats, cholesterol, salt, and added sugars.
Quit smoking.
Drink in moderation.
Manage stress.
Exercise.
Learn your family history.
Learn the ABCS of heart health:
appropriate aspirin therapy for those who need it
blood pressure control
cholesterol management
smoking cessation

“It’s a community effort,” said Goldberg. “We need to find the best ways that women of all backgrounds feel more comfortable in getting these messages. Sometimes having a national effort that is cookie cutter does not reach everyone. There really has to be a different strategy.”

What You Need to Know About Heart Disease in Women

Heart disease is a name for several abnormal conditions of the heart and blood vessels. These include:

coronary artery disease (blockages in the blood vessels around the heart)
peripheral artery disease (blockages in the blood vessels in the arms or legs)
problems with your heart’s rhythm (arrhythmia)
problems with your heart’s muscles or valves (valvular heart disease)
congestive heart failure (problem with the pumping or relaxation functions of the heart muscle)

These issues may develop over time or may be a result of abnormal formation of the heart in utero (before birth, called congenital heart disease). Heart disease is also called cardiovascular disease.

It’s often thought of as a health problem that mostly affects men. However, it’s the leading cause of death for women in the United States, responsible for about 1 in 4 female deaths each year.

Approximately 6 percentTrusted Source of U.S. women over age 20 have coronary heart disease or coronary artery disease, which is the most common type. The risk of heart disease increases with age.
Early signs of heart disease

Many women don’t have any symptoms of heart disease until they have an emergency such as a heart attack. However, if you do have early symptoms, they may include:

chest pain or discomfort, which can be either sharp, or dull and heavy (called angina)
pain in your neck, jaw, or throat
pain in your upper abdomen
upper back pain
nausea
fatigue
shortness of breath
general weakness
changes in skin color, such as grayish skin
sweating

These symptoms may occur either while you’re at rest or during activities of daily life. These can also be the symptoms of a heart attack.
Other heart disease symptoms in women

More symptoms may become apparent as heart disease progresses. Symptoms can differ depending on what specific type of heart disease you have.

The symptoms of heart disease in women are also different than in men, who are more likely to have chest pain.

Potential later symptoms of heart disease in women include:

swelling in your legs, feet, or ankles
weight gain
problems sleeping
your heart feeling like it’s beating very fast (heart palpitations)
coughing
wheezing
sweating
lightheadedness
indigestion
heartburn
anxiety
fainting

Risk factors for heart disease

Some types of heart disease are congenital, which means they’re a result of anatomical abnormalities in the way the heart was formed.

Genetic factors can also influence the chance of developing heart disease. Others can develop regardless of risk factors.

However, there are many other conditions and lifestyle factors that can put you at a higher risk of developing heart disease. These include:

diabetes
high blood pressure (hypertension)
depression
smoking
chronic stress
family history of heart disease
inflammatory diseases like rheumatoid arthritis and lupus
HIV
menopause or premature menopause
not exercising
having high blood pressure or diabetes during pregnancy
having overweight or obesity

There are also a number or conditions and issues for which having heart disease puts you at risk, including:

heart attack
stroke
heart failure
cardiac arrest
aneurysm

When to see a doctor

It’s never too early to see a doctor to discuss your risk for heart disease. In fact, the new primary prevention guidelines say that the earlier the risk factors for heart disease are prevented or treated, the less likely you are to develop heart disease later in life.

So, if you’re concerned about your risk for heart disease, make an appointment to discuss how you can prevent this highly preventable condition. You can connect to a cardiologist in your area using the Healthline FindCare tool.

If you’re having any symptoms at all, it’s very important to discuss these with your doctor as heart disease can masquerade in many different ways.

It’s easy to dismiss many warning signs of heart disease like fatigue, indigestion, and shortness of breath as just a normal part of life or mild illness. But because a heart attack can happen suddenly, it’s important not to ignore any potential warning signs.

If you have any of the above symptoms of heart disease, especially if you also have risk factors, see a doctor.

Medical Emergency

Call 911 if you have signs of a heart attack, including:

chest pain, heaviness, tightness, or pressure
sudden and severe arm pain
shortness of breath
losing consciousness
profuse sweating or nausea
a sense of doom

Diagnosing heart disease

To diagnose heart disease, a doctor will first ask about your personal and family medical history. They’ll then ask about your symptoms, when they started, and how severe they are. They’ll also ask about your lifestyle, such as if you smoke or exercise.

Blood tests can help a doctor figure out your risk for heart disease. The most common is a lipid profile, which measures cholesterol and triglycerides.

Depending on your symptoms and history, your doctor may do other blood tests, including tests to check:

inflammation levels
sodium and potassium levels
blood cell counts
kidney function
liver function
thyroid function
other specialized lipid tests

Other tests include:

Electrocardiogram (EKG) to measure electrical activity in the heart. This helps a doctor look at issues with your heart rhythm, as well as evidence of heart attacks.
Echocardiogram, which is an ultrasound of the heart and looks at your heart structure, function, and the performance of the heart valves.
Stress test to see how well your heart performs under physical stress. During this test, you’ll exercise while wearing equipment to measure your heart’s electrical signals and your blood pressure. It can predict whether you have blockages that may be limiting blood flow to your heart when you exercise.
Ultrasound of carotid arteries in your neck to look for stroke risk.
Ankle brachial index, the ratio of the blood pressure in your legs to your arms.
Coronary CTA, a specialized CT scan that looks at the blood vessels around the heart to see if there are blockages present.

A doctor might also suggest a continuous EKG or ambulatory arrhythmia monitor, where you wear a device that constantly records your heart’s electrical signals. Depending on your symptoms, you might wear this device for a few days or a few weeks.

If these tests are inconclusive, you may need more invasive tests to diagnose heart disease. These include:

Cardiac catheterization, which shows if your arteries are blocked and how well your heart is working.
Implantable loop recorder, which is an arrhythmia monitor implanted under the skin that helps determine the causes of arrhythmia (irregular heart beat).

Preventing heart disease

The risk factors for heart disease are complicated and include genetics, other biological factors, and general health and lifestyle factors.

While you may not be able to completely eliminate your risk for heart disease, you can take steps to reduce it. These include:

Get your blood pressure checked regularly. If it’s high, work with your doctor to lower it. This may include medication and lifestyle changes.
If you smoke, seek help to quit. This can be difficult, but a doctor can help create a smoking cessation plan that’s right for you.
If you have risk factors for diabetes, such as family history, get your blood sugar tested.
If you do have diabetes, keep blood sugar under control.
Maintain a weight that works for your body.
Eat a healthy diet that’s high in whole grains, fruits and vegetables, and lean meats.
Limit your alcohol intake to no more than one drink per day.
Manage stress levels.
Get your cholesterol checked and take steps to lower high cholesterol if you need to.
If you have sleep apnea, or believe you do, seek treatment.
Exercise regularly.
If you’ve had a heart attack, talk to your doctor about daily low-dose aspirin. This isn’t recommended for women who haven’t had a heart attack or stroke, as it can increase bleeding.

Takeaway

Heart disease is much more common in women than many people realize. In fact, it’s the leading cause of death for women.

Many women who have heart disease don’t have any symptoms. See your doctor early to determine your risk for heart disease and how you can reduce this risk.

If you do have symptoms, it’s important to see a doctor as soon as possible so they can test for heart disease and provide treatment before heart damage occurs.

How 12 Weeks of Stretching Can Improve Your Heart Health

Researchers say 12 weeks of passive stretching can improve blood flow and improve your heart health.
They say the stretching can reduce problems in a person’s vascular system and decrease the risk of events such as heart attack and stroke.
Experts say aerobic exercise, weight loss, and lower blood pressure are also ways to improve heart health.

Just 12 weeks of passive stretching can help the vascular system and improve blood flow, according to a new study.

Researchers from the University of Milan in Italy found that those who engaged in passive stretching had increased blood flow in their arteries and a decrease in artery stiffness.

“Blood pressure was decreased, central and peripheral arterial stiffness was reduced, and vascular function was increased after 12 weeks of passive stretching training,” the authors of the study wrote.

They note that this kind of stretching can improve a person’s heart health.

Passive stretching is a stretch where an external force provides the stretch. This can be through a stretching partner, stretching accessories, or gravity.

Active stretching doesn’t involve an external force.
What the study uncovered

The researchers enlisted 39 healthy men and women and split them into two groups.

One group was instructed to do leg stretches five times a week for 12 weeks, and the other group didn’t do any stretching.

Those who stretched saw an improvement to their vascular system. The researchers say this could have implications for diseases that involve changes to blood flow, such as heart attack and stroke.

“In this Italian study, there was a significant improvement in flow-mediated dilation, which can be thought of as the ability of an artery to dilate in response to an increase in blood flow,” said Jonathan Myers, PhD, a health research scientist and director of the Exercise Research Laboratory at the Palo Alto Veterans Affairs Health Care System in California.

“A novel finding from this study was the fairly remarkable changes in vascular function simply by passive stretching,” Myers told Healthline.

“This suggests that practitioners should routinely recommend stretching in addition to regular aerobic exercise for patients with vascular disease. The positive changes in arterial function by stretching were not as large as those generally considered to occur with aerobic exercise, but further studies are needed to determine the extent to which passive stretching can complement aerobic exercise.”

If the findings of the study were replicated in people with vascular disease, researchers could determine whether passive stretching may be a suitable treatment for improving vascular health.

“Exercise is one of the most effective ways to ensure healthy arteries, but a lot of the types of exercise that are most studied are cardiovascular focused such as running, walking, biking, swimming. This study is exciting because it shows similar benefits with non-cardio training,” said Dr. Nicole M. Weinberg, a cardiologist at Providence Saint John’s Health Center in Santa Monica, California.

“If this can be reproduced with vascular disease patients, perhaps it will change exercise programs, cardiac rehab, and other aspects of rehabilitation from vascular disease,” she told Healthline.
The dangers of vascular disease

“Vascular disease” is a term used to describe any abnormal condition of the arteries or blood vessels.

The vascular system in an adult is made up of 100,000 miles of blood vessels. Problems occurring within this system can be serious and cause pain, disability, or death.

Stroke, blood clot (pulmonary embolism), and heart attack can occur when blood flow is affected by arteries that are damaged or not working well.

“Good blood flow leads to reduced pressure within the system, leading to less damage on the wall of the artery. Reduction in blood flow due to artery/arteries not being compliant can lead to elevated blood pressure, which can increase risk of stroke and heart attack,” Dr. Sanjiv Patel, an interventional cardiologist at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in California, told Healthline.

Blood flow allows oxygenated blood to travel through the vascular system to tissues throughout the body. Without good blood flow, organs throughout the body are at risk.

“Good flow helps bring oxygenated blood to all our tissues. It is critical to have good blood flow to ensure that all the organs are working properly. Things that interfere with this have to do with arterial stiffness and blockage. Stiffness and blockage come from high blood pressure, high cholesterol, inflammation,” Weinberg said.

“Arterial stiffness is dangerous since once it sets in, it can be difficult to reverse. You want to address it early and work on mechanisms like stretching in the hopes of increasing the elasticity of the vessels,” she added.
How to improve your arteries

Dr. Neica Goldberg, a cardiologist and director of the NYU Langone Center for Women’s Health, said it’s important that arteries are flexible and not stiff.

“Arteries need to expand to deliver more blood to the heart muscle and muscles involved in activity during exercise or the abdominal arteries after a large meal. If they lose the ability to expand, it can provoke symptoms of chest pain or pain in the legs in people with peripheral artery disease,” she told Healthline.

Aerobic exercise, weight loss, and treating high blood pressure can reduce stiffness in the arteries. Medications such as statins can also help with flexibility.

“Regular exercise and keeping risk factors controlled are the most important things one can do ensure that arteries stay healthy. When disease is present, drugs can be helpful to dilate the arteries and to minimize pain if there is symptomatic peripheral vascular disease. The results from this study also suggest that stretching improves vascular function,” Myers said.

“This is important because the general impression has long been that aerobic-type exercises were generally required to favorably impact the health of the arteries.”

Emiliano Cè, PhD, an author on the paper, says that doing stretching could be beneficial for the vascular system during extended periods of confinement due to COVID-19.

“This new application of stretching is especially relevant in the current pandemic period of increased confinement to our homes, where the possibility of performing beneficial training to improve and prevent heart disease, stroke, and other conditions is limited,” Ce said in a press release.

But Goldberg says more research into stretching and its impact on the vascular system is needed.

“Right now, the stretching study is promising, but more data is needed in people who have heart disease, diabetes, high blood pressure, and other forms of vascular disease,” she said.

“Stretching is not enough to prevent heart disease based on this study.”

What Women Over 50 Should Know About Sitting and Heart Health

Sitting more during the day and for longer at a time is linked to a greater risk of cardiovascular disease in postmenopausal women.
In a new study, researchers looked at the sitting behavior of 102 Hispanic women and 416 non-Hispanic women.
Women’s cardiovascular symptoms also become more pronounced after menopause — although everyone’s risk for cardiovascular disease increases with age.

Exercise offers many health benefits, from reducing your risk for heart disease, stroke, and type 2 diabetes to strengthening your bones and improving your mental health.

But even regular exercise can’t undo all the negative health effects that come from spending much of your day sitting — something many of us probably do.

A new study adds more support to the idea that our modern, screen-filled, sedentary lifestyle is taking a toll on our health, including increasing our risk for cardiovascular disease.

Researchers found that postmenopausal women with overweight or obesity who spent more of their day sitting — or sitting for longer periods — had worse metabolic risk factors for cardiovascular disease.

This was true for both Hispanic and non-Hispanic older women, although there were some differences between the two groups.

“This study really shows how significant sitting is in terms of its effect on your heart,” said Dr. Suzanne Steinbaum, a preventive cardiologist from New York and a national Go Red for Women volunteer, who wasn’t involved in the new research.
Sitting linked to greater heart disease risk

In the new study, researchers looked at the sitting behavior of 102 Hispanic women and 416 non-Hispanic women. Women in both groups were postmenopausal and had overweight or obesity.

Information on the women came from three separate studies. Researchers, though, measured women’s sedentary behavior in the same way using wearable activity monitors.

This included measuring both the total time women spent sitting during the day as well as the average length of the sitting sessions.

Researchers focused on postmenopausal women because older Americans tend to have the highest levelsTrusted Source of sedentary behavior.

Women’s cardiovascular symptoms also become more pronounced after menopause — although everyone’s risk for cardiovascular disease increases with age.

This postmenopausal bump may be due to a decline in the level of the natural hormone estrogen.

This increased risk for older women happens even though they tend to be more active than older menTrusted Source.

In the new study, women who spent more of their day sitting or doing so in longer sessions had worse biomarkers related to cardiovascular disease. This included body mass index (BMI), waist circumference, fasting glucose, insulin resistance, and triglycerides.

The effect was more pronounced for women with obesity compared to overweight women.

This connection between sedentary behavior and cardiovascular disease risk remained even when researchers took into account women’s physical activity levels.

That means being sedentary was linked to a higher risk of cardiovascular disease even in women who exercised regularly.

Steinbaum says that when it comes to heart health, we need to think about physical activity and time spent sitting as two separate things.

“Does exercise make up for an exorbitant amount of sitting? The answer is no,” she said. “That’s why you should get up and move more often during the day.”

The authors of the new study write that more effort should be made by physicians and other healthcare providers to encourage people to not only exercise more, but also to sit less.

“Traditionally, clinicians focus on encouraging their patients to exercise more and increase physical activity with little focus specifically on sitting time,” the researchers write in the paper.

The new study was published Feb. 17 in the Journal of the American Heart Association.
Aim for more movement during the day

Researchers were also able to see whether sitting affected Hispanic women and non-Hispanic women differently.

On average, Hispanic women spent less of their day sitting and had shorter sitting sessions compared to non-Hispanic women.

Both groups saw a link between greater sedentary behavior and worse cardiovascular disease biomarkers.

But the link between the average length of the sitting session and fasting blood glucose was stronger for Hispanic women than for non-Hispanic women.

This fits with an earlier study that found self-reported sedentary behavior was linked to higher riskTrusted Source of type 2 diabetes, with differences seen among various racial and ethnic groups.

On the other hand, the link between total sitting time and BMI was stronger for non-Hispanic women than Hispanic women.

Because of the way the new study was designed, researchers were unable to say that increased sitting time causes the worsening of the biomarkers, only that the two are connected.

However, laboratory studies have found that frequently interrupting sitting sessions can improve health markers like glucose control and lipid metabolism.

Some studiesTrusted Source suggest that you should get up and move about every 30 minutes.

Steinbaum says you can also increase your heart rate at the same time by doing something like walking up and down a flight of stairs.

“Because of the profound effect sitting has on the metabolism and the risk factors for heart disease, physical activity needs to be part of our lives all day long, not just when we are consciously exercising,” she said.