Bien-êtreDécouvertes scientifiques 06/08/2025

Cardiovascular risk in women: an unknown enemy

Cardiovascular diseases are the leading cause of death among women. It is not breast or lung cancer. And yet, it is often mistakenly believed that heart diseases mainly affect men. An overview of this little-known and often neglected risk.  

In France, 8 women die every hour from a cardiovascular disease (CVD). That is 200 per day.

That is 6 times more than breast cancer.

It is also the leading cause of death among women in Switzerland. In 2023, cardiovascular diseases (CVDs) were responsible for 30% of women's deaths. 

And yet, the subject remains largely unknown and, above all, underestimated.

A neglected reality

If CVDs are the leading cause of death among women, it is crucial to understand the risk factors and specific symptoms for better prevention and management. However, there is a real gap between medical reality and risk perception. 

Indeed, there are beliefs about what worsens cardiovascular health, what the symptoms of a heart attack are, or what the warning signs of a stroke are. This is notably due to the fact that historically, cardiovascular research and prevention have been designed by and for men. The result: female symptoms are poorly understood, diagnoses are often late, and warning signals are minimized. 

But good news: science is increasingly interested in this subject. Doctors, gynecologists, researchers, and institutions are actively studying risk factors, specific symptoms, and possible prevention levers. A promising dynamic for more adequate and effective care.

Specific risk factors

Since there are biological differences between men and women, especially at the endocrine level, there are also different risk factors regarding cardiovascular health in men and women. 

The specific risk factors in women are:

- Vitamin D deficiency: it is linked to an increased cardiovascular risk by influencing blood pressure, inflammation, and bone and vascular health.

- Chronic stress, mental load, anxiety, and depression: this infernal trio for the heart, very common in women, increases blood pressure, heart rhythm disorders, and inflammation.

- Low-grade inflammation: Silent but persistent, it is favored by sedentary lifestyle, unbalanced diet, or overweight, and constitutes a favorable ground for cardiovascular diseases.

The major role of hormones

Moreover, the different hormonal stages in women play a major role as a risk factor. 

- Hormonal contraception: Some pills, especially first or second generation, can slightly increase cardiovascular risk, especially in cases of smoking, hypertension, or family history.

- High-risk pregnancy: Pregnancy hypertension, pre-eclampsia, or gestational diabetes are not trivial: they are considered early warning signs of an increased long-term cardiovascular risk. Special vigilance is therefore recommended after delivery, with appropriate follow-up.

- Gynecological history: endometriosis, polycystic ovary syndrome (PCOS), or early menopause are all signals not to be ignored: these are red flags that should trigger early cardiovascular monitoring.

Menopause: a key turning point

This is a major turning point in women's cardiovascular health. 

Up to this stage, estrogens play a protective role by acting as a shield for the heart and vessels. But from 45-50 years old, estrogen levels drop sharply, and with them, cardiovascular protection. 

The benefits of estrogens on the cardiovascular system:

- Increase good cholesterol (HDL)

- Slow down bad cholesterol (LDL)

- Maintain artery flexibility

- Regulate blood pressure

- Stabilize blood sugar

What their decline causes after menopause:

- Increase in LDL and decrease in HDL, promoting artery clogging

- Vessel stiffening, with elevated blood pressure

- Glycemic instability, increasing diabetes risk

- Chronic inflammation and oxidative stress, worsening overall cardiovascular risk

Result: after age 50, heart attacks and strokes become more frequent in women, sometimes without warning signs. This shift is still too often ignored or poorly anticipated, whereas appropriate monitoring could make all the difference. 

And what about hot flashes?

Long trivialized, they are nevertheless not harmless. When intense, frequent, or prolonged, they are a potential indicator of an underlying vascular imbalance. So it’s not "just a hot flash" but a symptom to take seriously and discuss with your doctor for effective prevention.

Different symptoms

Yes, women’s hearts beat differently from men’s, both anatomically and physiologically. 

Women generally have a smaller heart, narrower arteries, and their heart beats faster. Moreover, the female heart is more sensitive to certain risk factors like stress. 

 These particularities influence not only their cardiovascular function but also how heart diseases manifest. 

Atypical symptoms... and often trivialized

Contrary to popular belief, warning signs of a heart attack or other cardiac event are not always dramatic, nor centered on the chest. 

In women, they can be more subtle, more diffuse, and unfortunately often minimized.

The most common symptoms in women are:

• Unusual or persistent fatigue, without apparent reason
• Sudden shortness of breath, even at rest or during moderate effort
• Nausea, abdominal pain, or heartburn sensation, difficult digestion
• Unexplained anxiety or feeling of malaise
• Diffuse pain in the back, jaw, neck, or arms
• Dizziness, palpitations, or cold sweats
• Sleep disturbances

Chest pain, often considered the "classic" symptom of a heart attack, is also present in women, but it can manifest as tightness, discomfort, or pressure, rather than sharp pain. Some women do not feel any at all.

Another specificity: these symptoms can occur at rest, during sleep, or during ordinary activities, and not necessarily during exertion, which further complicates their recognition.

That is why it is crucial to know and recognize them. 

The lack of recognition of these symptoms has serious consequences. Women are often diagnosed later than men, sometimes too late. They are also more likely to suffer severe complications following a heart attack.

Better knowing the specific signs in women allows for earlier diagnosis, better care, and therefore, saves lives. Sudden shortness of breath, unusual fatigue, or pain in the jaw should never be trivialized. If one or more of these symptoms appear suddenly or unusually, it is essential to consult quickly.

Good habits to protect your heart

And on the prevention side, what do we do?

1. Move regularly
Engaging in physical activity is essential: ideally, walk 30 minutes a day, and complement with a cardio activity like running, cycling, dancing, or swimming once a week.

2. Eat a balanced diet
Adopting a healthy diet helps maintain good cardiovascular balance. It is recommended to consume omega-3s, fruits and vegetables, as well as fiber, while reducing the intake of sugar, salt, and saturated fats.

3. Manage your stress
Chronic stress is an aggravating factor for the heart. Practices like meditation, deep breathing, or sophrology can help, but it is also simply about allowing yourself to slow down when the body or mind feels the need.

4. Do not wait to consult
A cardiovascular assessment is recommended from age 45, especially in case of personal or gynecological risk history. Early evaluation allows for preventive action rather than reacting to an already established problem.

It is especially important to plan a complete cardiac assessment (blood pressure, cholesterol, blood sugar, inflammation), an inventory of gynecological and hormonal history, and a review of perimenopause symptoms.

This allows for integrated care linking the heart, inflammation, hormones, and lifestyle. 

5. Choose natural allies
Some dietary supplements can support cardiovascular health alongside a healthy lifestyle. Omega-3, vitamin D, and natural antioxidants play a recognized beneficial role for the heart.

• Pomegranate: known for cardiovascular health, it helps reduce bad cholesterol and supports blood regeneration. Rich in phytoestrogens, it also provides relief from menopause symptoms thanks to its composition similar to human estrogens.
• Omega-3: helps reduce inflammation and improve lipid profile.
• Curcumin: a powerful natural anti-inflammatory, it helps improve blood circulation, reduce inflammation of vascular walls, and limit cholesterol oxidation, three mechanisms involved in preventing heart diseases.

Conclusion

Cardiovascular diseases are not inevitable.

But they remain little known and invisible for women, especially their links with hormones and particularly menopause. It is a factor not to be overlooked and to discuss with your gynecologist and primary care physician to have appropriate support taking into account your medical history. All while opting for a healthy lifestyle, with adapted nutrition and natural allies for support.  

 

To read, share, and spread: this article can save lives.

 

Sources:

The woman's heart – American Hospital of Paris - https://www.american-hospital.org/pathologie/le-coeur-de-la-femme

Women and cardiovascular diseases – World Heart Federation - https://world-heart-federation.org/fr/what-we-do/women-cvd/ 

Women more exposed to risk factors - Act for women's heart -  https://www.agirpourlecoeurdesfemmes.com/anticiper/facteurs-de-risque/Les-femmes-plus-exposees-aux-facteurs-de-risque#:~:text=La%20pr%C3%A9%2D%C3%A9clampsie%2C%20l%27hypertension%20gravidique%20et%20le%20diab%C3%A8te,de%20pr%C3%A9vention%20adapt%C3%A9es%20(Eur%20Heart%20J%202016

Linkedin - Peggy Pères - https://www.linkedin.com/in/peggy-p%C3%A8res-012b61a9/

Cardiovascular diseases in women: a largely underestimated risk – Axa - https://www.axaprevention.fr/fr/article/maladie-cardiovasculaire-femmes 

Cardiovascular diseases in women: red alert – Act for women's heart - https://www.agirpourlecoeurdesfemmes.com/alerter/maladies-cardio-vasculaires/Maladies-cardio-vasculaires-des-femmes-alerte-rouge 

Women's health: a cardiovascular risk not to be overlooked – FRM https://www.frm.org/fr/maladies/recherches-maladies-cardiovasculaires/sante-cardiovasculaire-des-femmes/focus-sante-cardiovasculaire-des-femme