Cardiovascular Health in Women

By Ann Marie Navar, M.D., Ph.D.

Associate Professor of Internal Medicine

Cardiovascular disease is the No. 1 cause of death for women in the United States. While most women are aware of traditional risk factors for cardiovascular disease, such as high blood pressure, diabetes, or elevated LDL cholesterol, many women are unaware that their reproductive history may impact their risk of heart disease.

As part of a session on cardiovascular risk at #AHA21, I presented an overview of risk factors for cardiovascular disease in women. Importantly, many “traditional” risk factors are both more common in women and more likely to cause heart disease than in men, including diabetes, hypertension, physical inactivity, obesity, and inflammatory diseases such as lupus. Women are also more likely than men to experience depression, which is known to be associated with heart disease.

What about risk factors specific to women? Pregnancy is nature’s ultimate stress test, and many women experience complications of pregnancy such as hypertension, preeclampsia, gestational diabetes, or preterm delivery. Multiple studies have shown that these complications all increase a person’s long-term risk of cardiovascular disease. Premature menopause is also a risk factor for heart disease.

The latest ACC/AHA cholesterol guidelines emphasize screening for potential “risk enhancers” specific to women, including age at menopause and prior pregnancy complications. When one of these risk enhancers is present, particularly in women at an intermediate to high 10-year risk of cardiovascular disease, clinicians should be vigilant in lowering cardiovascular risk via lifestyle, blood pressure control, and statin therapy to lower LDL cholesterol and prevent cardiovascular events.

Email: ann.navar@utsouthwestern.edu

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