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You might think that heart disease is a man's problem. In fact, heart disease is the number one killer among women. Even breast cancer claims fewer lives. That's why it's recommended that women should take action to keep their hearts healthy and lower their risk of having a heart attack or stroke.
Here are four things that women need to know about heart health and pregnancy:
Heart disease in women may be overlooked or missed
Heart disease is the leading cause of death in the United States for both men and women. A recent study shows more women are more concerned about their risk of breast cancer than heart disease, and awareness of heart disease has gone down. Heart disease in women can be overlooked or missed and as a result it can be undertreated.
"More than 40% of reproductive-age people who could become pregnant have at least one chronic medical condition or obstetric risk factor," said Victoria Chase, MD, a maternal fetal medicine physician with Intermountain Health who specializes in high-risk pregnancy. "And some women may not know they have symptoms or risk factors such as high blood pressure or diabetes that make them more at risk for heart disease before they get pregnant, during pregnancy, or after childbirth."
Some women may not recognize their symptoms until it is serious. Or they may know they have health conditions but haven't talked to a doctor about it or aren't being treated for it before becoming pregnant. These conditions and other factors can make them more at risk for developing a heart condition or complications during pregnancy.
Identify and treat risk factors early
It's important to identify risk factors for heart disease and get those risks treated before pregnancy or very early in pregnancy.
"If a woman is thinking about getting pregnant and is older or has health conditions, it's important to talk to a health provider before getting pregnant. If a woman is already pregnant, it's important to see a health provider very early in the pregnancy, to get those risks identified, treated or monitored, as they could affect mom or baby," Chase said.
If heart conditions go unrecognized or untreated, women can be at risk for heart attack or death. Because women's heart disease symptoms are different than men's symptoms, their conditions may be under-recognized by women themselves and by health professionals.
There may be biases in healthcare and inequities in care that contribute to under-recognition and undertreatment of heart conditions in women. There are health disparities and social barriers that people face that prevent them from seeking care, such as financial worries, lack of social support, poor understanding of health-related issues, or they are too busy with life.
Known risk factors for heart disease for both women and men
Conditions women can identify and control include: lifestyle choices, high blood pressure, diabetes, smoking or vaping, obesity, activity levels, high cholesterol and getting at least eight hours of nightly sleep.
How women's symptoms are different
Many times, the symptoms of a heart attack in women are similar to men – crushing chest pain. But sometimes symptoms may be vague, such as shortness of breath, nausea or fatigue. As a result, women and care teams may miss heart disease and attribute symptoms to anxiety or other conditions. Sometimes other symptoms may overshadow a woman's complaint of chest pain.
"Maternal mortality – or death during pregnancy or within a year of childbirth – is higher in the U.S. than in most other high-resource countries. There are many factors that contribute to this sad statistic, but chief among them are diabetes, chronic hypertension, chronic heart disease, and obesity. Identifying and treating these conditions before pregnancy is crucial to improving obstetrical outcomes in our country," Chase said.
For women with a heart condition or other high-risk health conditions who are considering pregnancy, the maternal fetal medicine department at Intermountain Medical Center has a Pregnancy Preparation, Prevention and Risk Evaluation (PrePPARE) Clinic which offers pre-pregnancy risk assessments and evaluations. Call 801-507-7400 for more information.
