Risk Factors for Heart Disease
Women have a lack of appreciation of their individual risk for heart disease. Women do not associate heart disease as being part of their disease "spectrum" and don't pay attention to their risks. While most women have asked their relatives about family history of cancers, especially breast or ovarian cancers, few ask about heart disease, especially occurring at an early age. While many women know that their cholesterol is "okay", few know whether the breakdown of individual components in the lipid or cholesterol values puts her at increased or reduced risk.
Coronary Heart Disease (CHD) risk factors include those we cannot modify:
increasing age |
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| women get their heart disease an average of 10 years later than men | |
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family history of early coronary heart disease |
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| a family history of heart disease in a woman is a stronger predictor of heart disease than a family history of disease in a man | |
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diabetes mellitus |
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| more women than men get diabetes; diabetes removes the age differential for heart disease in women; a woman with diabetes has 3 to 7 times the risk of heart disease while a man with diabetes has 2 to 3 times the risk | |
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African-American race |
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| African-American women have the greatest risk of heart disease of any gender or ethnic group, with heart disease their number one cause of death after age 25 | |
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male gender (for early CHD only) |
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The coronary heart disease risk factors that we can modify include:
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lipid levels (total cholesterol, LDL, HDL, Lp(a) and triglycerides) |
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| LDL is considered the greatest predictor of heart disease in men, while HDL, Lp(a) and triglyceride levels appear to be greater predictors for women | |
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hormonal status |
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| the female hormone (estrogen) is a powerful deterrent to CHD; a premenopausal woman gets heart disease less often while a post-menopausal woman the same age will have twenty times the chance | |
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tobacco use |
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| teenage women are the group that are increasing their smoking the most; teenage smokers find it hardest to quit; a woman who smokes gets her first heart attack 19 years earlier than a nonsmoker, compare to 7 years earlier for a male smoker | |
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hypertension |
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| women develop hypertension more often than men after age 45; over half of all women over age 64 have hypertension | |
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left ventricular hypertrophy (thickening of the heart muscle) |
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physical activity |
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| 60% of women report no regular physical exercise or activity | |
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obesity, especially around the waist area |
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| obesity is more common in women, impacting many other risk factors | |
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antioxidant level |
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environmental tobacco smoke |
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elevated levels of homocysteine |
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| clotting factors |
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| clotting abnormalities can cause a heart attack, more often seen immediately after pregnancy, in women on oral contraceptives, and in the months after restarting hormones after menopause | |
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endothelial function (how the heart blood vessels respond to stress) |
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| estrogen maintains normal blood vessel responses to stress, even in the face of blood vessel damage; estrogen improves lipid levels and reduces inflammatory changes in blood vessel lesions | |
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personal response to overall stress levels |
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Many of these risk factors have a special impact in women which is substantially different from that in men. Because these are so common, the unique aspects of risk factors for CHD in women must be taken into account.
Last updated on October 17, 2002.