How is Heart Disease Different in Women vs. Men?

Medically reviewed by Kris Roloff RN BSN, quality care coordinator at Network Health
5/14/2024

Both men and women have hearts (obviously), so it comes as no surprise that both men and women can suffer from heart disease. How men and women experience heart disease, however, can be significantly different. This can be a problem.

It’s a problem because the lack of awareness of heart disease in women can lead both doctors and patients to misinterpret symptoms, leaving the door open for a delayed diagnosis. In fact, heart disease is the leading cause of death for women in the United States.

According to the Centers for Disease Control and Prevention (CDC), common types of heart disease in women include coronary artery disease (a build up of plaque in blood vessels that deliver blood to the heart), arrhythmia (a heartbeat that is too slow, too fast or irregular) and heart failure. The challenge for health care providers and patients in identifying heart disease isn’t due to the type of condition, however, as it has more to do with the symptoms.

Heart Disease Symptoms in Women vs. Men

Heart disease in women doesn’t always present the same way as it does in men. The symptoms in women can be more subtle, making them difficult to detect. Women are also less likely to have common symptoms.

For example, with heart attacks, both men and women most commonly experience chest pain or discomfort. Other symptoms that women may often share with men include pain in the jaw, neck or back, shortness of breath and nausea or vomiting. But there are other symptoms that may appear with a heart attack in women that are not typical with men, including the following.

• Pain or pressure in the lower chest or upper abdomen, one or both arms, back, neck or jaw
• Fainting
• Indigestion (heartburn)
• Extreme fatigue
• Lightheadedness or dizziness
• Nausea and vomiting
• Shortness of breath

These symptoms are less often associated with a heart attack and could be indicative of other conditions. Telltale heart attack symptoms may not always be present.

Why Are There Sex-Specific Differences with Heart Disease?

Much of the reason women experience heart disease differently than men comes down simply to anatomy. For instance, women have smaller blood vessels and heart chambers, are more likely to be affected by changes in body position, typically have higher estrogen levels that can impact heart health and have fewer red blood cells, meaning their blood can carry less oxygen per volume.

Coronary artery disease is also less common in women and, on average, occurs at an older age than it does in men. This could lead to heart disease diagnoses being less obvious in women patients.

How to Identify Heart Disease in Women

Women are more likely than men to experience what is called “silent heart disease,” which means there are no symptoms. If you do have symptoms of heart disease, however, a few to watch out for include the following.

• Heart palpitations
• Sudden or severe weakness or fatigue
• Swelling in legs, ankles or feet
• Ongoing or bloody cough
• Shortness of breath, whether resting or during activity

[Read more: When to Be Concerned About Your Heart Skipping Beats]

Since symptoms are not always present or obvious, it is wise to be aware of heart disease risk factors as well. Risk factors that are typical in both women and men include high cholesterol, obesity and high blood pressure. Risk factors that may affect women more than men include the following.

• Emotional stress
• Depression
• Diabetes
• Menopause
• Smoking
• Inactivity
• Family history of heart disease

In the case of diabetes, the disease can change the way you feel pain. This means that the “silent heart disease” we mentioned can be a particular risk if you have diabetes as well.

What Women Can Do to Prevent Heart Disease

Understanding risk factors above is the first step to preventing heart disease. Having this knowledge can put you in a position where you and your personal doctor can better monitor your health and create steps for prevention. These steps often come in the form of managing any current health conditions you have, such as diabetes or high cholesterol.

There is no magic method for heart disease prevention. Making the right healthy choices is your best approach, including maintaining a healthy weight, being physically active (even if you start slow) and eating foods that are better for your heart like fruits, vegetables and whole grains. If you smoke, you should make a plan to quit. Your personal doctor can help you with all of this and provide you with resources to put you on a path toward improving your well-being.

Can Aspirin Prevent Heart Disease?

Some people follow a low-dose aspirin regimen as a means of preventing cardiovascular disease, which includes heart disease. You may have heard of this before. So, does it work?

The answer isn’t a simple one. The U.S. Preventive Services Task Force (USPSTF) released recommendations in 2022 for low-dose aspirin use as a means of cardiovascular disease prevention. The USPSTF concluded that people over age 60 should not use a low-dose aspirin regimen for this purpose if they have no history of the disease. Those age 40-59 who are at an increased risk of a heart attack or stroke due to diabetes, high blood pressure or other factors may consider a low-dose aspirin regimen at the recommendation of their personal doctor. Remember to first consult your doctor before starting or stopping such a regimen, as it can come with severe side effects for some people.

[Learn More About the USPSTF Recommendations for Low-Dose Aspirin]