Pink ribbons are instantly recognizable as the symbol of Breast Cancer Awareness, and they often adorn everything from yogurt cups to t-shirts to body wash. The marketing effort is to encourage women to get screened for mammograms for prevention and early detection, and it’s working. One study found that public awareness of breast cancer is credited with decreasing breast cancer mortality by up to 20% due to early detection.
While these efforts have shined a spotlight on the importance of breast cancer awareness, doctors agree that there should be just as much emphasis on preventive care and consciousness-raising to heart health. The reason is because it is estimated that one in eight women will get breast cancer in their lifetime, but cardiovascular disease kills more women than all forms of cancer combined.
“Although heart disease rates continue to rise, studies have shown that more than half of US adults aren’t aware that it is the leading cause of death,” says Stephanie Saucier, MD, Director, Women’s Heart Wellness Program at Hartford Hospital in Hartford, Connecticut. “It’s important for everyone, including women, to take heart disease seriously.”
Heart disease is the #1 killer of women.
According to the American Heart Association, nearly half (44%) of women are unaware that heart disease is the leading cause of death for women. There are certain factors and life events and stages that can increase women’s chances of developing heart disease, such as family history, high blood pressure, pregnancy, and menopause.
“For example, when a woman is experiencing menopause, their hormone levels are more likely to shift, which can also lead to changes in their bad cholesterol levels and put them at a greater risk for heart disease,” says Dr. Saucier. She adds that during menopause, there is often a rise in weight and a rise in risk of hypertension. All of these factors are risk factors for developing heart disease.
“Interestingly, women who have a history of gestational diabetes or preeclampsia during pregnancy have an increased risk of heart disease when they are older,” says Dr. Saucier. “Women are also more likely [than men] to have rheumatologic disease such as rheumatoid arthritis, which is its own risk factor for developing heart disease.”
And research demonstrates that some people are more at risk for heart disease, including Black women, who are more likely to have high cholesterol levels. Studies have shown that social factors, like poverty and access to healthcare, predispose Black women to develop heart disease. Black women also are at higher risk to develop heart disease and have poorly treated hypertension, which is another main risk factor for heart disease.
What other equally important health threats exist for women?
In addition to cardiovascular disease and breast cancer, women have a greater risk of having a stroke, poorer stroke outcome, and have a poorer quality of life after a stroke compared to men, according to a 2019 pooled analysis.
“This is still an area of active study, however, we do know that women tend to live longer, and are older at the time of their stroke than men,” says Felipe De Los Rios, MD, Director of Stroke Care at Miami Neuroscience Institute. “Stroke tends to happen more often and with more severe consequences as we age. This could in part explain why women have a greater risk of stroke and worsen stroke outcomes than men.” Pregnancy and early menopause are other factors that are unique to women and can be associated with a lifelong increase in stroke risk.
Another growing concern is lung cancer. According to the American Lung Association, lung cancer diagnoses have risen a startling 84% among women over the past 42 years. The main risk factors for lung cancer are smoking or secondhand smoke, and symptoms typically present themselves in the form of chest pain, prolonged coughing, persistent weakness or fatigue.
And most recently colorectal cancer cases have skyrocketed, with more and more women under 50 being diagnosed. Abnormal growths, called polyps, can form in the colon or rectum, and if left untreated, these abnormal growths can turn into cancer and grow through the walls of the colon and into the rectum.
While all of these cancers occur in men, Fatima Khan, MD, Assistant Professor in Cardiovascular Medicine at the University of Texas Medical Branch says it’s important to know that women do not have the same signs and symptoms as men do, specifically when it comes to heart health.
“Most of the literature in the books and educational material is based on the research done on men, since we did not know for ages that heart disease can also impact women,” says Dr. Khan.
Because of this it’s important to consult with your doctor about your own health concerns and risks and know what symptoms to look for.
How to reduce your risk of heart disease and protect your health
Doctors agree that the first step for women to take action for their heart health is knowing the hidden signs of heart disease.
As opposed to men who usually have chest pain, jaw and left arm discomfort, women are less likely to have these typical symptoms. Women usually have vague symptoms like fatigue, stomach pain, upper back or chest discomfort that does not feel like severe pain at all. Women may also present with upset stomach symptoms like burning chest, burping, and indigestion.
“Another reason why women should take their heart health seriously is because heart disease is often referred to as a ‘silent killer,’ meaning that it is often symptomless,” says Dr. Saucier. “For example, high cholesterol — which can lead to a heart event — has no symptoms. It is so important to be proactive about your health, especially when it comes to knowing your cholesterol levels after you’ve had a heart event.”
Systemic hormone therapy, particularly estrogen, also has the potential to significantly preserve your body’s function, says Kelly Casperson, MD, urologist and Flow Space Advisory Council member. It can decrease cardiovascular events and death, especially when started within 10 years of the menopause transition.
“This highlights the importance of early intervention and the role we can play in our own health,” says Dr. Casperson. “The benefits of hormone therapy include less heart disease, less joint pain, preservation of bone and muscle health, and decreased risk of depression in some studies. We need to start thinking about the conservation of function and what we can do now to be healthy and vital future selves when we are 75.”
Other prevention methods include knowing your family history, and if any relatives have had heart disease, you might be at a higher risk. You can also monitor for certain signs — like shortness of breath or chest pain — but there are others that you wouldn’t notice yourself, like high cholesterol, which you can monitor through regular check-ups with your doctor.
Dr. Saucier adds that women should get 150 minutes of moderate intensity exercise per week, minimize sugary drinks, maintain a healthy weight, and try to get seven to nine hours of sleep per night to also help minimize their risk.
While breast cancer is a major health concern for women, consulting with your doctor about any and all health concerns and having routine annual screenings for your whole body health are also crucial.
“Knowledge is power,” says Dr. Saucier. “So knowing your risk and your numbers will help you have meaningful shared decision making with your provider.”