Risk Factors

Cardiovascular disease, including stroke, claims more women’s lives than the next seven causes of death combined — nearly 500,000 a year, nearly twice as many as all forms of cancer.


You can do a lot to prevent cardiovascular disease and stroke. It begins by learning all you can about these serious health threats and working to reduce your risks. More research needs to be done on heart disease and stroke in women, but we already can share a lot of life-enhancing information. Educate yourself and your family. Then do something about it.

Public Enemy No. 1: Heart Disease and Stroke

One in 2.5 women will die of heart disease or stroke, compared with one in 30 from breast cancer. But you can substantially reduce many of your risk factors for heart disease and stroke with a few simple lifestyle changes. And if you've already had heart disease or a stroke, the lifestyle changes can help you to a more successful recovery.

What is cardiovascular disease?


Cardiovascular disease includes diseases of the heart and blood vessels. Most heart and blood vessel problems develop over time and occur when your arteries develop atherosclerosis – a process that begins in childhood and involves a gradual build-up inside them called plaque. This plaque contains fat, cholesterol and other substances. Plaques can grow large enough to significantly reduce the blood's flow through an artery. But most of the damage occurs when a plaque becomes fragile and ruptures. Plaques that rupture cause blood clots to form that can block blood flow or break off and travel to another part of the body. If either happens and blocks a blood vessel that feeds the heart or brain, it causes a heart attack or stroke.

What is stroke?

Stroke is a type of cardiovascular disease. It affects the arteries leading to and within the brain. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, part of the brain can't get the blood (and oxygen) it needs, so it starts to die.

When part of the brain dies from lack of blood flow, the part of the body it controls is affected. Strokes can cause paralysis, affect language and vision, and cause other problems. Treatments can minimize the potentially devastating effects of stroke, but to receive them, a person must recognize the warning signs and act quickly! (For more information about stroke and its effects, visit StrokeAssociation.org.)

Is women's health risk due to gender difference or gender bias?

Probably some of both. Several factors may explain the apparent disparity in treatment of men and women:
In the past, many of the major cardiovascular research studies were conducted on men. Results of clinical studies under way may help clarify the gender differences that affect diagnosis and treatment of women with heart disease.
Clinicians and patients often attribute chest pains in women to noncardiac causes, leading to misinterpretation of their condition.
Both women and men may present “classic” chest pain that grips the chest and spreads to the shoulders, neck or arms. Women may have a greater tendency to have atypical chest pain or to complain of abdominal pain, difficulty breathing (dyspnea), nausea and unexplained fatigue.
Women may avoid or delay seeking medical care, perhaps out of denial or not being aware of both typical and atypical heart attack symptoms.
Since women tend to have heart attacks later in life than men do, they often have other diseases (such as arthritis or osteoporosis) that can mask heart attack symptoms. Increased age and the more advanced stage of coronary heart disease in women can affect treatment options available to physicians. Increased age can also help explain women's greater mortality after heart attacks.
Some diagnostic tests and procedures may not be as accurate in women, so physicians may avoid using them. That means the disease process resulting in a heart attack or stroke may not be detected in women until later, with more serious consequences.
The exercise stress test, or stress ECG, may be less accurate in women. For example, in young women with a low likelihood of coronary heart disease, an exercise stress test may give a false positive result. In contrast, single-vessel heart disease, which is more common in women than in men, may not be picked up on a routine exercise stress test.
More precise noninvasive and less invasive diagnostic tests tend to cost more. These include thallium, sestamibi or echocardiographic stress tests.