What is the leading cause of death for women in the United States?
If you guessed heart disease (or if this headline gave you a hint), you are correct—but more than half of women don’t know the right answer to this question. In a new Circulation special report, the American Heart Association revealed a significant decline in women’s heart disease awareness since 2009, particularly among younger women and women of color. Their findings make clear the urgent need to spread the word about heart health, and to dispel existing myths about heart disease and gender. No one is immune, and it benefits all of us to understand our risks and methods of prevention.
A Concerning Trend
AHA researchers analyzed survey data from women 25 years and older to learn who recognized heart disease as the leading cause of death among women. They found that between 2009 and 2019, awareness decreased for all ages and racial groups except for women 65 years old and above. The decline in awareness was greatest among Hispanic women, non-Hispanic Black women, and 25- to 34-year old women.
The reason for this decline in awareness is not totally clear. Mary Cushman, M.D., professor of medicine and pathology at the University of Vermont in Burlington, explains that healthcare disparities may play a role in women’s understanding of their heart disease risk. “Because of the racial differences we observed, we can speculate that systemic racism or lack of trust in the system among people of color might have something to do with it,” Dr. Cushman says. “Also, awareness was lower in younger women, so those of us who work with young women, like their families, teachers and healthcare providers can now recognize this gap in knowledge in younger women and work to correct it.”
When you picture someone with heart problems, you might imagine your grandfather, your uncle, or another elderly man in your life. But the data tells a different story: one in 16 women over 20 years old have coronary heart disease. “Women think it won’t happen to them,” Dr. Cushman says. “And based on our findings, many women do not know it is their leading killer. Like most diseases, it can be prevented through lifestyle change and use of appropriate preventive medications.”
The groups least likely to know their risk for heart disease are also among the most vulnerable to it. CDC data shows that non-Hispanic Black adults are the most likely to have hypertension; Hispanic and non-Hispanic Black adults are most likely to have obesity; and Hispanic and non-Hispanic Black adults are most likely to have diabetes. These are all risk factors for cardiovascular disease.
“I’m especially concerned about women of color – especially Black women and Hispanic women,” Dr. Cushman notes. “This is of urgent concern since heart disease death is more common in these women than white women.”
Flipping the Script
The saying “knowledge is power” couldn’t be truer in this case. There is plenty you can to do prevent or reverse heart disease, even if you already have one or more risk factors. Dr. Cushman hopes to see improved education about heart disease, starting as early as grade school. “Healthcare providers need to talk about it with their patients, but moreover, it should be discussed everywhere people live, work, play and pray,” she says. “All of us can help fix the misconceptions so that when the next AHA survey is done, we see a turnaround in these results.”
Here’s Dr. Cushman’s advice for taking care of your heart, starting right now.
- Prioritize yourself. “Women tend to care for others before themselves, but they just need to be more aware of their own self-care,” she says. Be diligent about attending routine doctor’s visits and making time to stay active and eat well.
- Practice healthy habits. Not to be a broken record here, but small daily choices do matter! “Practice healthy lifestyle choices like regular physical activity, healthy food choices, and not smoking or quitting if you do,” Dr. Cushman advises.
- Open up a conversation with your doctor. Your doctor is a great resource for better understanding your heart disease risk. “Talk to your healthcare provider about your personal level of risk, and treat risk factors like hypertension aggressively,” she says.
- Learn the heart attack signs and symptoms. “Know that you must take an aspirin and call 9-1-1 if having symptoms,” Dr. Cushman urges. Heart attack symptoms are different for women than men. The most common symptom for both genders is chest pain and discomfort, but women are more likely to experience shortness of breath, back or jaw pain, and nausea. Other things to watch out for: cold sweats and lightheadedness.
Want to help change the narrative around women and heart disease? Dr. Cushman suggests signing up to participate in Research Goes Red, an initiative by the American Heart Association’s Go Red For Women movement. You can join focus groups, research studies, and more to help advance heart research for women of all ages. Let’s spread the word!