We know that women and men are different, but sometimes, when it comes to disease, it’s hard to appreciate what that difference means. For example, heart disease is the leading cause of women in Canada dying early. Why is that?

Heart disease affects women differently. Part of that is anatomical; women generally have higher heart rates and smaller hearts and arteries than men. This makes women’s arteries more prone to blood clots or blockages and more difficult to repair.

Some risk factors are also a red flag for women. While men and women share most of the same risk factors, some of them, like smoking, diabetes, high blood pressure, and a family history of heart disease, pose an even greater threat for women than for men. Plus, it’s believed that estrogen protects against heart complications, but once estrogen levels drop during menopause, the risk of heart disease rises. Being older also means women are more likely to have other conditions, such as diabetes, that can further increase risk and complicate a diagnosis.

Heart attack symptoms can also differ. For both men and women, the most common sign of a heart attack is chest pain or discomfort, but women can experience a heart attack without chest pressure. They may experience shortness of breath, dizziness, lightheadedness or fainting, upper back pressure or extreme fatigue. Because symptoms in women can be less specific, they can be harder to recognize as danger signs.

This is why it’s important to educate yourself about your risk factors and talk about them with your health care practitioner. Here are risk factors to be aware of:

Medical risk factors

• High blood pressure
• High cholesterol levels
• Pre-eclampsia (high blood pressure during pregnancy)
• Diabetes
• Atrial fibrillation (an irregular heart rhythm)
• Age – especially after menopause
• South Asian, African, or Indigenous heritage
• Family history of heart disease or stroke/TIA (transient ischemic attack)

Lifestyle risk factors

• Unhealthy diet
• Not enough exercise
• Unhealthy weight
• Smoking
• Birth control or hormone replacement therapy
• Heavy drinking
• Stress

For more information about women’s heart health, visit the Heart and Stroke Foundation of Canada website, or speak to your health care practitioner.