Why Does The Most Preventable Disease Kill 1 in 5 Women?

Hands with painted heart

About once every 90 seconds, a woman’s life is taken by heart disease. That’s more than the top 4 other leading causes of death combined, which include all cancers, diabetes, dementia, and lung conditions.

Why has this rate remained so high when 80% of cardiovascular conditions are entirely preventable? (1)

Ensuring the health of your heart starts with recognizing risk factors, and staying consistent with a few basic lifestyle behaviors. Remain mindful, and stick with them, and you’ll be doing your best for a strong, healthy heart.

Why Is Heart Disease the #1 Killer of Women

Perhaps the most pervasive myth in cardiovascular health today is that we tend to think of heart disease as a “man’s problem”. We’ve been taught to recognize male-specific signs and symptoms, neglecting to understand that women present very differently.

Many medical schools in the U.S. operate under the assumption that a 70-kg male is the medical norm, and anything different is just a variation upon that baseline. Thankfully, this notion is beginning to change. However, we now know that there are sex or gender differences in almost every medical condition–not just heart disease (2).

Almost half the adult population in the U.S. has some form of cardiovascular disease, but 45% of women don’t know it’s their leading cause of death, and 71% never or rarely discussed heart health with their doctor–mostly due to more urgent health concerns at the time (3).

Due to decreased awareness, women often overlook symptoms of cardiovascular disease as well. They dismiss their symptoms–thinking they won’t be taken seriously, or don’t recognize them because they don’t seem like the norm (meaning, they’re not clutching their chest in pain).

Because of this, women are less likely to seek treatment for heart problems, therefore complicating their condition further, and delaying preventative measures.

How Does Heart Disease Affect Women

During the reproductive years, women seem to be at much lower risk for heart disease than their age-matched male counterparts, and this is thanks, in part, to the production of estrogen. Estrogen is cardio-protective in that it aids in the production and healthy dilation of blood vessels, and decreases things like oxidative stress and damage to tissues (4).Heart display

As women progress into menopause, though, these factors change, and we sky-rocket to the top of the list for heart disease risk. We’ll talk about risk factors and what you can do to improve them in a moment. 

The umbrella of heart disease covers almost a dozen different cardiovascular conditions ranging from arrhythmias (irregular heartbeats) and myopathies (blood flow problems) to myocardial infarctions (heart attacks) and coronary artery disease (CAD). Women can be at risk for any number of cardiovascular conditions, though the most prevalent is CAD, which is the narrowing or blockage of the main artery that supplies blood to the heart.

All cardiovascular conditions affect either the function of the heart muscle, the vessels or arteries, or the heart rhythm.

Simply put, we need the heart to pump blood efficiently, bring oxygen to all parts of the body, and we need to do that via healthy arteries.

Signs and Symptoms of Heart Disease in Women

Acute heart problems, like heart attacks or changes in heart rhythm, are more easily recognized. The “silent” problems like high blood pressure, or compromised blood flow to the heart, are a little more difficult to notice.

Heart attacks in women are very often delayed in their diagnosis–therefore increasing mortality rate, or mistaken altogether–especially while they’re happening.

Lesser-known heart attack symptoms for women include:

  • Indigestion, nausea, or vomiting
  • Pain in the neck, jaw, or back
  • Feeling dizzy or lightheaded
  • Breaking out in a cold sweat
  • Shortness of breath
  • Unusual fatigue

Contrary to what’s portrayed in film, many heart attacks happen without significant chest pain, which might contribute to women dismissing their symptoms. Some may even mistake them for an anxiety or panic attack, as they can share similar feelings (nausea, sweating, dizziness). The bottom line: you know your body–if you feel something isn’t right, always err on the side of caution and have yourself checked out.

The signs of an unhealthy heart develop over time, and their warning signs may be more subtle. If the heart is having trouble pumping blood through the body, you may experience:

  • Lightheadedness during normal activities
  • Shortness of breath performing minimal activity
  • Weight gain
  • Problems sleeping even though you feel fatigued
  • Anxiety
  • Fainting spells

Some of these signs or symptoms are broad, and they can indicate any number of health conditions (and sometimes they’re even benign), so that’s why it’s important to take into account what puts you at risk for heart disease, so you can be mindful of your individual risk.

Women’s Risk Factors for Heart Disease

Heart disease and stroke can affect women of any age, so it’s not just a concern for “older” women, and there are a few lesser-known factors for heart disease women must be mindful of.

  1. Inflammation and sugar. A diet high in processed grains, vegetable oils, sugar, and high-fructose corn syrup leads to increased inflammation in the body and higher cholesterol levels.
  2. Sedentary lifestyle. Today, the disease of sitting is responsible for claiming 3.2 million lives per year. Spending an average of 12 hours per day sitting decreases blood flow to the limbs, and promotes weakening of the heart muscle over time (5).
  3. Poor diet. The standard American diet is nutritionally bankrupt and leaves us sorely lacking in Woman with headacheheart-healthy nutrients.
  4. Stress increases the risk of high blood pressure and contributes to cortisol dysfunction.
  5. Metabolic disorders (diabetes, hypertension, cholesterol imbalance). Blood sugar balance, insulin levels, and healthy lipid metabolism are all integral factors for a healthy heart.

Emerging research shows that mental health significantly impacts heart health by placing stress on the cardiovascular system. Depression creates systemic inflammation, which can cause plaque deposits within arteries to harden, contributing to atherosclerosis. Stress hormones brought on my mental health issues can weaken the response of the heart to demands for increased blood flow (6).

One study showed that women with depression were twice as likely to experience a cardiovascular event within the next 18 years, compared with women who did not have depression (7).

Methylation Markers

Why has the integrative medical community been buzzing about methylation? The methylation process is driven by an enzyme called methyltetrahydrofolate reductase (MTFHR), and this enzyme is a common genetic variant that can cause this key enzyme to function at a much lower than normal capacity. This makes it difficult for our body to detoxify hormones, chemicals, and other metabolic toxins, in addition to processing nutrients.

This is important because poor methylation status significantly affects our ability to properly convert some forms of B vitamins to the active form the body can use. B12, folate, and B6 play a major role in cardiovascular function, the production of red blood cells, and the ability to reduce the inflammatory amino acid, homocysteine. When there is a buildup of homocysteine in the body, we’re at higher risk for atherosclerosis (hardening of the arteries), and poor cardiovascular health. Homocysteine levels are often high in men and women with methylation defects.

To ensure you’re properly absorbing B vitamins, supplement with a fully-methylated B complex, like Boost, that contains the active forms of B vitamins your body can actually use.

What’s the Deal with Cholesterol?

One in four Americans are now taking a statin drug to lower their cholesterol, but is it the right choice for everyone? And is high cholesterol the same risk for everyone?

The conversation about total cholesterol has been a little oversimplified. We now know that total cholesterol doesn’t give us the whole picture of our heart disease risk.

Without cholesterol, your body wouldn’t be able to:

  • Make cell membranes
  • Produce hormones (estrogen, testosterone, cortisol, etc.)
  • Provide fuel for the heart
  • Make brain cells

Cholesterol is a vital part of every cell in our body, and without it, we’d die. The more complicated conversation involves the ratios of what kinds of cholesterol are present in our body, and how our diet and lifestyle can affect those ratios.

A lot of the foods that we traditionally think of as “healthy” contribute to chronic inflammation and disease more often than we realize. Find out What Doctors Eat and you’ll never have to worry whether or not your diet is right for you.

In the 1950s, researcher Ancel Keys proposed the “lipid hypothesis” for dietary cholesterol and heart disease. Simply stating that eating more saturated fat contributes to heart disease. Against pushback from the scientific community, recommendations to reduce or eliminate saturated fat and animal fats became widely accepted.

This was a radical change at the time, and as Americans cut out these calorie-dense foods from their diet, they were left feeling hungry and increased consumption of convenience foods, sugars, and flour, which can lead to imbalanced triglycerides and the “good” cholesterol.

75% of our body’s cholesterol is produced in the liver, and it’s production is significantly influenced by insulin levels, so maintaining a healthy blood sugar balance is imperative to healthy cholesterol (8). 

Elevated cholesterol can be a result of digestive or liver dysfunction, as cholesterol is absorbed in the gut. Having a healthy, humming gut is a major part of an overall cholesterol management plan.

Tips for A Naturally Healthy Heart

Eat fiber-rich foods. Vegetables, nuts, seeds, minimally processed grains, flax. Excess cholesterol binds to dietary fiber and is excreted from the body via our stool. And fiber not only supports healthy cholesterol levels but provides fuel for healthy gut bacteria as well, which is especially important since certain types of oral bacteria can cause infections in the heart (9).Eat for your Power Type to avoid systemic inflammation and promote healthy gut bacteria.

Reduce processed grains and sugar. Excess sugars and carbohydrates in the diet promote insulin resistance and blood sugar imbalance, which can result in fatty deposits in the blood (known as triglycerides) and an imbalance between HDL cholesterol and triglycerides.

Avoid smoking and drinking. Smoking decreases blood flow and oxygen capacity in the blood, and drinking to excess can raise blood pressure and weaken the heart muscle over time.

Limit stressors and incorporate prayer or meditation. Just 7 minutes per day has been shown to improve inflammatory markers.

Avoid industrialized seed oils. Include healthy plant fats and Omega-3s. 

Limit red meat to twice per week, and when you do consume animal products, choose grass-fed or pasture-raised.

Move! The human body was meant to move–so whether it’s stretching, walking, yoga, or strength training, whatever your body is capable of is better than not moving at all! Aim for 150 minutes per week, divided however you like. This increases blood flow and strengthens the muscle of the heart.

There is no one approach to heart health that works for every single person, but there are some basics that most everyone should follow–not only to ensure a healthy heart but other systems as well. Ultimately, the heart is part of the body, so the food choices and lifestyle habits that create a healthy body are a simple way to promote the health of your heart, too.

Do you know someone who needs to live a more heart-healthy lifestyle? Share this blog and connect them with this useful information!



  1. https://www.heart.org/en/get-involved/advocate/federal-priorities/cdc-prevention-programs
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5073801/
  3. https://www.acc.org/latest-in-cardiology/articles/2017/06/22/10/01/women-and-heart-disease-new-data-reaffirm-lack-of-awareness-by-women-and-physicians
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655818/
  5. https://www.juststand.org/the-facts/
  6. https://www.health.harvard.edu/heart-health/depression-and-heart-disease-a-two-way-street
  7. https://www.sciencedirect.com/science/article/abs/pii/S0165032715309253?via%3Dihub
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903787/
  9. https://www.heart.org/en/news/2019/11/19/bacteria-in-your-spit-might-play-a-role-in-heart-disease