Women and heart health: The conversation we need to be having

By Joe Ackerman, RN, STEMI and Chest Pain Coordinator, UP Health System

When people think about the biggest health risks facing women, heart disease often does not top the list. Cancer, breast health or reproductive concerns are usually the first things that come to mind. The reality, however, is clear: cardiovascular disease is the leading cause of death among women in the United States.

Despite this, fewer than half of women recognize heart disease as their greatest health threat. That lack of awareness matters because heart disease does not develop overnight. It progresses quietly over time, often beginning much earlier in life than most women realize.

Nearly half of women age 20 and older are living with some form of cardiovascular disease, including conditions such as high blood pressure. Many feel well and experience no symptoms, making it easy to overlook risk factors such as elevated cholesterol, family history or other cardiovascular risks. These early indicators are often the first signs that heart health needs attention, long before a serious event occurs.

For many women, pregnancy can provide important insight into future heart health. Conditions such as high blood pressure during pregnancy, preeclampsia and gestational diabetes are not only temporary complications. They are associated with a significantly higher risk of developing cardiovascular disease later in life. Heart disease is also a leading cause of pregnancy-related death among new mothers and accounts for a substantial share of maternal deaths nationwide. Black women experience some of the highest maternal mortality rates, underscoring persistent disparities in health outcomes.

As women move into midlife, cardiovascular risk can continue to increase. Menopause itself does not cause heart disease, but the transition often coincides with changes in hormones, metabolism, blood pressure and cholesterol levels that can accelerate existing risk factors. This stage of life represents a critical opportunity to focus on prevention, regular screenings and heart-healthy habits.

The encouraging news is that many cardiac events and strokes are preventable. Regular physical activity, balanced nutrition, stress management and controlling blood pressure can significantly reduce risk. Education plays a vital role in prevention. When women understand their individual risk factors and take early action, outcomes improve.

High blood pressure remains one of the most common and underrecognized threats to women’s heart health. Often referred to as the “silent killer,” hypertension frequently presents without symptoms. More than half of deaths related to high blood pressure occur in women, and rates are particularly high among Black women. Routine screening and ongoing management are essential, even for those who feel healthy.

Stroke is another area in which women are disproportionately affected. While millions of women are living as stroke survivors, women account for many stroke-related deaths. Recognizing warning signs and managing risk factors such as high blood pressure and heart rhythm disorders can be lifesaving.

In emergency situations, women also face an additional challenge. Women are less likely than men to receive bystander CPR during cardiac arrest. Hesitation, fear and misconceptions about providing care can delay critical intervention, even though immediate CPR can significantly increase survival rates. Continued education and community training are key to closing this gap.

There is also more work to be done in research. Women remain underrepresented in cardiovascular clinical trials, limiting how well heart disease is understood and treated across the population. Increasing representation in research is essential to improving prevention, diagnosis and care for women.

At the center of all these issues is awareness. Heart disease in women is common, serious and often preventable. By increasing education, encouraging early and ongoing heart care, and addressing disparities in research and treatment, we can change outcomes.

Heart disease is a women’s health issue — at every age and every stage of life.