8 Unexpected Factors That Can Increase Women's Risk of Heart Disease

When doctors assess a patient’s risk of heart disease, they typically ask about their diet and family medical history, while also taking their blood pressure and cholesterol into consideration. This information provides some insight into women’s heart health, but it only tells part of the story, according to a recent statement from the American Heart Association (AHA), published in the journal Circulation in April 2023.

“Risk assessment is the first step in preventing heart disease, yet there are many limitations to traditional risk factors and their ability to comprehensively estimate a woman’s risk for cardiovascular disease,” Jennifer H. Mieres, M.D., a professor of cardiology at Hofstra Northwell, and co-author of the report said in the AHA statement. 

The hazards surrounding women’s heart health have remained poorly understood for decades. Through the 1990s, research on risk factors and treatments for heart disease was conducted almost exclusively on white men. When women could finally take part in these studies, most were postmenopausal —leaving doctors with a limited understanding of cardiovascular health in younger women.

Another issue is the lack of reliable data for people of color. When researchers use data from large patient registries to create heart disease risk assessment formulas, they often exclude women of color. As a result, most registries are in need of more racial and ethnic health information. 

Though there has been some progress in understanding women’s heart health. Scientists have recognized that the signs of an upcoming heart attack look different in women than men. Additionally, the current methods for assessing a woman’s risk of cardiovascular disease need improvement. In fact, according to the American Heart Association’s recent scientific statement, the following risk factors aren’t taken into account:

Pregnancy-related conditions

The expecting mother’s blood volume rises by 45 percent and even up to 50 to 60 percent in the late third trimester to feed the growing fetus. The drawback is that the heart is working harder than usual to pump the extra blood. Labor and delivery can also put a strain on the heart as it causes drastic changes to blood flow and pressure. Pregnancy-related conditions such as preeclampsia, gestational diabetes, preterm delivery, gestational high blood pressure, and miscarriage are also associated with heart problems.

Menstrual cycle history

Research suggests the timing of a girl’s first period can somewhat predict their risk of heart problems. Compared to women who menstruated at 13 years old, those who had their period before 10 or after 17 were 27 percent more likely to die or need hospitalization for heart disease in the future. Additionally, they were 16 percent more likely to die or need urgent medical care because of a stroke. Having irregular periods — those that fall outside the standard 22- to 34-day range — also increased the risk of heart disease and heart attack.

Use of hormonal contraceptives

Birth control containing estrogen makes it easier for blood clots to form. If there are enough blood clots, it can block blood from flowing to your heart muscle. If the clot blocks an artery in charge of circulating blood to the brain, it may cause a stroke. This risk applies to pills, patches, implants, vaginal rings, and injections.

Related story

Weight Loss Drug Wegovy Could Lower Your Risk for Heart Disease