VCS Blog
Specific Risk Factors for Women and Heart Disease
Heart disease is often thought of as a men’s health issue—but it is the leading cause of death for women in the United States. Many women are surprised to learn that heart disease risk can begin early in adulthood and develop quietly over time, long before symptoms are obvious.
Understanding your personal risk factors—and how heart disease can present differently in women—is one of the most important steps you can take to protect your heart.
Medically reviewed by board-certified cardiologists at Virginia Cardiovascular Specialists. Content reviewed annually or as clinical guidelines change.
Understanding Heart Disease in Women
Heart disease is a broad term that includes conditions affecting the heart’s blood vessels, structure, rhythm, and function. The most common form is coronary artery disease, which develops when plaque builds up in the arteries and restricts blood flow to the heart.
In our cardiology practices, we frequently care for women who are diagnosed later than men—not because their disease is less serious, but because symptoms may be more subtle or overlooked. Early evaluation and preventive care can significantly reduce complications and improve long-term heart health.
Learn more:
Why Women’s Heart Disease Risk Is Different
Women share many traditional heart disease risk factors with men, but they also face unique biological, hormonal, and life-stage-related risks that deserve special attention. Research from the National Heart, Lung, and Blood Institute highlights that women’s risk is often underestimated—by both patients and healthcare providers.
Hormonal changes across a woman’s life, including menopause, can influence cardiovascular risk. For some women, hormone replacement therapy (HRT) may be part of care, but underlying heart risk factors should be considered as part of informed decision-making. Understanding personal cardiovascular risk before starting or adjusting hormone therapy can help guide safer, more confident choices.
In our experience caring for women across all stages of life, these differences matter when it comes to screening, diagnosis, and treatment.
Common Heart Disease Risk Factors for Women
Some risk factors cannot be changed, but many can be managed with the right care and lifestyle support.
Traditional risk factors include:
- High blood pressure
- High cholesterol
- Diabetes or prediabetes
- Overweight or obesity
- Smoking or long-term exposure to secondhand smoke
- Physical inactivity
- Poor sleep (fewer than 7 hours per night)
- Chronic stress
- Family history of heart disease
Even one risk factor increases your likelihood of developing heart disease. Multiple risk factors can compound each other and accelerate cardiovascular damage.
Risk Factors That Are Especially Important for Women
Pregnancy-Related Conditions
Conditions such as preeclampsia, gestational diabetes, and pregnancy-related high blood pressure are associated with increased heart disease risk later in life. These conditions should be part of long-term cardiovascular follow-up—not viewed as temporary issues that end after pregnancy.
Hormonal Changes
Menopause is associated with changes in cholesterol levels, blood pressure, and body fat distribution. These shifts can increase cardiovascular risk, particularly when combined with other factors.
Autoimmune and Inflammatory Conditions
Conditions such as lupus and rheumatoid arthritis—more common in women—are associated with higher rates of heart disease due to chronic inflammation.
Atypical Symptoms
In our cardiology clinics, women often describe symptoms such as fatigue, shortness of breath, nausea, jaw pain, or back pain rather than classic chest pain. These differences can delay diagnosis if not recognized.
Cancer Treatment–Related Heart Risk
Some cancer treatments can increase the risk of heart disease years, even decades, after treatment. Research has shown that women who received chest radiation or certain chemotherapy medications may face higher long-term cardiovascular risk.
Women who may benefit from proactive heart evaluation include those with a history of:
- Breast cancer treated with chest radiation
- Childhood or young adult cancers (such as Hodgkin lymphoma)
- Certain chemotherapy regimens known to affect heart function
Prior cancer treatment does not mean heart disease is inevitable, but it does mean heart health deserves ongoing attention and informed screening.
How to Assess Your Personal Risk
Women often experience heart disease symptoms that don’t match the “classic” warning signs many people expect. In our cardiology clinics, women frequently report symptoms such as fatigue, shortness of breath, nausea, jaw pain, back pain, or lightheadedness rather than chest pain alone.
These differences are widely recognized by national organizations such as the American Heart Association, which outlines common heart attack warning signs in women.
Learn More:
- Women’s Heart Disease at VCS
- Preventive Cardiology & Wellness
- American Heart Association: Heart Attack Symptoms in Women
How to Lower Your Risk of Heart Disease
Many heart disease risk factors are manageable with the right support. In our preventive cardiology programs, we work with women to create realistic, sustainable plans that address lifestyle, medical history, and individual health goals.
Heart-healthy steps include:
- Following a balanced, heart-healthy eating pattern
- Staying physically active (aiming for at least 150 minutes per week)
- Managing stress and prioritizing sleep
- Maintaining a healthy weight
- Avoiding tobacco
- Tracking key health numbers over time
For some women, lifestyle changes alone may not be enough—and medication may play an important role. Preventive care is not about perfection—it’s about progress and partnership.
It’s Never Too Early—or Too Late—to Start
One of the most important messages we share with patients is this: it’s never too early to protect your heart. The choices you make today can influence your heart health for decades to come.
If you have questions about your risk—or want to take a proactive approach to your heart health—our cardiology team is here to help.
Take the Next Step in Protecting Your Heart
Understanding your risk is the first step toward protecting your heart.
Request an appointment with a board-certified cardiologist
————————
This content was developed and reviewed using current clinical guidance and public health resources, including:
- National Heart, Lung, and Blood Institute (NHLBI) – The Heart Truth® and women’s heart disease education resources
- American Heart Association – Women’s heart disease and heart attack symptom awareness materials
Medical Review:
Medically reviewed by board-certified cardiologists at Virginia Cardiovascular Specialists.
Published February 9, 2026