Cardiovascular diseases are the leading cause of death among women, accounting for around 37 per cent of all deaths. These include, in particular, coronary heart disease (CHD). Despite its significance, the condition is often diagnosed later in women—not least because it presents differently from the classic “textbook heart attack.”
Other symptoms, later diagnosis
Instead of the typical chest pain, women more often experience nonspecific symptoms such as shortness of breath, nausea, back pain, or severe fatigue. Because these symptoms are less obvious, the correct diagnosis is often not made until later—a delay that can be critical in cases of cardiovascular disease.
Risk Factors—and Why They Affect Women More Severely
As the INTERHEART study has impressively demonstrated, approximately 90% of all heart attacks can be attributed to modifiable risk factors. These include, among other things, high blood pressure, smoking, lipid metabolism disorders, diabetes mellitus, obesity, lack of physical activity, and a genetic predisposition.
It is particularly important to note that some of these factors have a greater impact on women: For example, smoking increases cardiovascular risk in women by about 25–30% more than in men, and diabetes mellitus is also associated with a significantly higher relative risk of cardiovascular events in women.
Factors Specific to Women
In addition to the traditional risk factors, there are other factors that specifically affect women and are becoming increasingly important. These include, in particular, pregnancy complications such as preeclampsia, gestational diabetes, gestational hypertension, and preterm births. These events are not merely temporary risks during pregnancy; they are considered important early indicators of an increased risk of cardiovascular disease later in life—which can be two to four times higher.
Autoimmune diseases such as rheumatoid arthritis or systemic lupus erythematosus, chronic stress, depression, as well as hormonal factors and treatments also play a significant role.
Menopause changes the risk profile
Menopause also brings about changes in the cardiovascular risk profile. Among other things, declining estrogen levels lead to an increase in LDL cholesterol, increased abdominal fat, more frequent spikes in blood pressure, and a decrease in vascular elasticity. These changes contribute to the development and progression of atherosclerosis.
Preventive Care: Risk Assessment Starting at Age 40
Against this backdrop, current European guidelines recommend regular cardiovascular risk assessment for women starting at age 40—or earlier if risk factors are present. Early detection and targeted prevention can significantly reduce the risk of cardiovascular disease.
I would be happy to assist you in assessing your individual cardiovascular risk and developing a tailored preventive strategy—in a calm and personal setting.
