Cardiovascular disease (CVD) is the leading cause of death in women. In fact, 1 in 5 women in the U.S. dies from heart disease. Today, about 44% of women are living with some form of cardiovascular disease, and nearly half of women younger than 45 already have at least one major heart disease risk factor.
While women share many traditional risk factors with men — such as high blood pressure, high blood sugar, and high cholesterol — there are risk factors unique to women that can begin as early as their 20s and increase cardiovascular risk across a lifetime.
What risk factors are unique to women?
Pregnancy‑related conditions
Pregnancy is often described as an early life “cardiovascular stress test.” Certain pregnancy complications signal a higher long‑term risk for heart disease, including:
- High blood pressure during pregnancy
- Preeclampsia
- Gestational diabetes
- Delivering a preterm or low birth weight baby
These conditions were once thought to fully resolve after delivery. We now know that their effects on heart health can persist well beyond pregnancy. About 10 to 15% of women experience at least one of these complications.
Menopause
Menopause is another important life transition closely tied to heart health. It is defined as 12 months without a menstrual period, after which estrogen levels decline, contributing to increased cardiovascular risk.
Many women first develop high cholesterol or high blood pressure during this time. Other common menopausal changes, including sleep disruption, loss of lean muscle mass, and increased abdominal fat, may also raise heart disease risk.
When menopause occurs before age 45 (called early menopause), heart disease risk increases four to five times compared with menopause at a later age.
Hormone replacement therapy (HRT) may help relieve menopausal symptoms for some women and may reduce cardiovascular risk when started in the right woman at the right time (typically between ages 50 and 59). Because HRT decisions are highly personalized, it is important to discuss it with your health care provider.
Autoimmune conditions
Several conditions that are more common in women are linked to higher cardiovascular risk, including:
- Lupus
- Rheumatoid arthritis
- Polycystic ovary syndrome (PCOS)
These conditions are associated with chronic inflammation, metabolic changes, or hormonal imbalance — all of which can accelerate heart disease.
How can I better understand my heart disease risk?
Know your numbers
Regular screening is essential. Ideal targets include:
- Blood pressure: less than 120/80 mmHg
- Fasting blood glucose: less than 100 mg/dL
- LDL (“bad”) cholesterol: less than 100 mg/dL
You can also ask your clinician about additional blood tests that may help identify risk earlier, such as:
- Lipoprotein(a) [Lp(a)] – recommended to be checked at least once in a lifetime
- Apolipoprotein B (ApoB)
- High‑sensitivity C‑reactive protein (hsCRP)
Steps you can take to lower heart disease risk
Once you know your personal risk, you can focus on steps that have been scientifically shown to significantly reduce heart disease:
- Avoiding tobacco use
- Getting 7 to 9 hours of quality sleep each night
- Eating a variety of whole foods, including fruits, vegetables, whole grains, and heart‑healthy fats
- Engaging in regular physical activity — at least 30 minutes of moderate exercise most days
- Managing blood sugar, since diabetes increases CVD risk even more in women than men
- Practicing sustainable weight management behaviors
- Knowing your cholesterol and blood‑pressure levels and working toward personalized goals
Understanding these risk factors unique to women can make a difference in protecting your heart health. For more information and resources on women and heart disease, visit the Penny Anderson Women's Cardiovascular Center.
