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Cardiovascular disease risk factors and heart attack warning signs in women
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Cardiovascular disease risk factors and heart attack warning signs in women

Information for healthcare professionals and the public on cardiovascular disease risk factors and warning signs affecting women.

Key takeaways

  • Chest pain is the most common heart attack symptom affecting women (and men). However, women are more likely than men to experience non-chest pain symptoms including jaw, shoulder or back pain, nausea or vomiting, dizziness, shortness of breath/difficulty breathing, indigestion or fatigue/tiredness.
  • In addition to traditional cardiovascular disease risk factors, the risk of a heart attack or stroke can also be affected by women-specific risk factors.
  • If you are a woman aged 45 and over (or 30 and over for Aboriginal and/or Torres Strait Islander women), speak to your GP about your risk of heart attack and stroke and have a Heart Health Check.
2 min read

The risk of cardiovascular disease in women changes throughout life’s course. It is important for the public and healthcare professionals to be aware of the risk factors and heart attack warning signs affecting women.  

If you are a woman aged 45 and over (or 30 and over for Aboriginal and/or Torres Strait Islander women) speak to your GP about your risk of heart attack and stroke and have a Heart Health Check. Let your GP know if you have any of the risk factors mentioned below. Read more about the Heart Health Check.

If you are a healthcare professional, the below risk factors are important to consider when determining a woman’s absolute cardiovascular disease risk. Read more about absolute cardiovascular disease risk assessment.

Risk factors for cardiovascular disease in women

In addition to traditional cardiovascular disease risk factors, the risk of a heart attack or stroke may also be affected by women-specific risk factors.1, 2 When talking to a new doctor, it is important to mention these conditions as part of your personal history, so they can take it into account.  


Read more about each risk factor below.  

Aboriginal and/or Torres Strait Islander women

Aboriginal and/or Torres Strait Islander women are almost twice as likely as non-Indigenous women to have cardiovascular disease.2

Aboriginal and/or Torres Strait Islander women aged 30 and over should see their GP for a heart check. Read more, here

If you are a healthcare professional, read more about absolute cardiovascular disease risk assessment for Aboriginal and/or Torres Strait Islander peoples.

Warning signs of a heart attack in women

Know the full range of warning signs of a heart attack. Chest pain is the most common heart attack symptom affecting women (and men).  

However, women are more likely than men to experience non-chest pain symptoms including jaw, shoulder or back pain, nausea or vomiting, dizziness, shortness of breath/difficulty breathing, indigestion or fatigue/tiredness.  

Women under 50 years of age present more often with non-chest pain symptoms of cardiovascular disease.1

If you are experiencing unusual symptoms and think you might be having a heart attack, do not delay seeking help, call triple zero (000) right away. Read more, here.

If you are a healthcare professional, it is important to make sure your patients are aware of heart attack warning signs. Read more, here


References

1. Dreyer RP, Sciria C, Spatz ES, Safdar B, D’Onofrio G, Krumholz HM. Young women with acute myocardial infarction: current perspectives. Circulation: Cardiovascular Quality and Outcomes. 2017;10(2):e003480.
2. Australian Institute of Health and Welfare. Cardiovascular disease in women Cat no CDK 15. Canberra: AIHW; 2019.
3. El Khoudary SR, Aggarwal B, Beckie TM, et al. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation. 2020;142(25):e506-e532.
4. Taylor JE, Baig MS, Helmy T, Gersh F. Controversies Regarding Post-Menopausal Hormone Replacement Therapy for Primary Cardiovascular Disease Prevention in Women. Cardiology in Review. 2020;
5. Rosano GMC, Maffei S, Andreassi MG, et al. Hormone replacement therapy and cardioprotection: a new dawn? A statement of the Study Group on Cardiovascular Disease in Women of the Italian Society of Cardiology on hormone replacement therapy in postmenopausal women. Journal of Cardiovascular Medicine. 2009;10(1):85-92.
6. Streed CG, Jr., Harfouch O, Marvel F, Blumenthal RS, Martin SS, Mukherjee M. Cardiovascular Disease Among Transgender Adults Receiving Hormone Therapy: A Narrative Review. (1539-3704 (Electronic))
7. Nota Nienke M, Wiepjes Chantal M, de Blok Christel JM, Gooren Louis JG, Kreukels Baudewijntje PC, den Heijer M. Occurrence of Acute Cardiovascular Events in Transgender Individuals Receiving Hormone Therapy. Circulation. 2019/03/12 2019;139(11):1461-1462. doi:10.1161/CIRCULATIONAHA.118.038584
8. Connelly Paul J, Marie Freel E, Perry C, et al. Gender-Affirming Hormone Therapy, Vascular Health and Cardiovascular Disease in Transgender Adults. Hypertension. 2019/12/01 2019;74(6):1266-1274. doi:10.1161/HYPERTENSIONAHA.119.13080
9. Roos-Hesselink J, Baris L, Johnson M, et al. Pregnancy outcomes in women with cardiovascular disease: evolving trends over 10 years in the ESC Registry Of Pregnancy And Cardiac disease (ROPAC). European heart journal. 2019;40(47):3848-3855.
10. Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, et al. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy. Kardiologia Polska (Polish Heart Journal). 2019;77(3):245-326.
11. Rana S, Lemoine E, Granger Joey P, Karumanchi SA. Preeclampsia. Circulation Research. 2019/03/29 2019;124(7):1094-1112. doi:10.1161/CIRCRESAHA.118.313276
12. Patel SS, Truong U, King M, et al. Obese adolescents with polycystic ovarian syndrome have elevated cardiovascular disease risk markers. Vascular Medicine. 2017;22(2):85-95.
13. Okoth K, Chandan JS, Marshall T, et al. Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review. BMJ (Clinical research ed). 2020;371:m3502-m3502. doi:10.1136/bmj.m3502
14. Geraghty L, Figtree GA, Schutte AE, Patel S, Woodward M, Arnott C. Cardiovascular disease in women: from pathophysiology to novel and emerging risk factors. Heart, Lung and Circulation. 2020;
15. Roshanisefat H, Bahmanyar S, Hillert J, Olsson T, Montgomery S. Multiple sclerosis clinical course and cardiovascular disease risk–S wedish cohort study. European journal of neurology. 2014;21(11):1353-e88.
16. Harbo HF, Gold R, Tintoré M. Sex and gender issues in multiple sclerosis. Therapeutic advances in neurological disorders. 2013;6(4):237-248.
17. Okwuosa Tochi M, Morgans A, Rhee J-W, et al. Impact of Hormonal Therapies for Treatment of Hormone-Dependent Cancers (Breast and Prostate) on the Cardiovascular System: Effects and Modifications: A Scientific Statement From the American Heart Association. Circulation: Genomic and Precision Medicine. 0(0):HCG.0000000000000082. doi:10.1161/HCG.0000000000000082
18. O’Neil A, Fisher AJ, Kibbey KJ, et al. Depression is a risk factor for incident coronary heart disease in women: An 18-year longitudinal study. Journal of Affective Disorders. 2016/05/15/ 2016;196:117-124.
19. Garcia M, Mulvagh Sharon L, Bairey Merz CN, Buring Julie E, Manson JoAnn E. Cardiovascular Disease in Women. Circulation Research. 2016/04/15 2016;118(8):1273-1293. doi:10.1161/CIRCRESAHA.116.307547


Last reviewed: 6/10/2021

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