Heart disease affects men and women differently, necessitating tailored approaches in prevention and treatment. Recent studies reveal a widening gender gap in cardiovascular care, highlighting unique disparities in male and female physiology, risk factors, and symptoms.  

Here are 10 key insights into how heart disease impacts women, from biological differences to the implications of various life stages – including risk level and the way women respond to treatment.

1. Prevalence. Over 60 million women (44 percent) in the United States are living with heart disease,^[1] making it the leading cause of death among women. In 2023 alone, heart disease accounted for 1 in 5 female deaths.
   
   
2. Heart physiology and symptoms. Women often experience additional heart disease symptoms than men due to differing physiology. Women have smaller heart mass and arteries than men. While chest pain is a common indicator for men, women may also experience less obvious symptoms, including shortness of breath, nausea, fatigue, jaw pain, and dizziness, which can complicate diagnosis.^[2]
   
   
3. Communication gaps. There is a notable lack of communication about heart health between women and their health care providers. Many women remain unaware of their cardiovascular risks, and when they initiate a conversation about heart attack symptoms, those symptoms may be misattributed to anxiety.^[3]
   
   
4. Diagnostic challenges. Women have a 50 percent higher chance than men of receiving an incorrect initial diagnosis after a heart attack. The majority of women experience chest pain, but women also experience more non-chest pain symptoms, regardless of the presence of chest pain. As a result, both women and their healthcare providers are less likely to attribute their symptoms to heart disease compared with men.^[4]
   
   
5. Cardiovascular disease in young women. Nearly 45 percent of women aged 20 and older live with some form of cardiovascular disease. Less than half of women entering pregnancy in the U.S. have optimal cardiovascular health, and conditions such as pregnancy and menopause can heighten cardiovascular disease risk.^[5]
   
   
6. Exercise and protection. Women may need less physical activity than men to achieve comparable reductions in coronary heart disease (CHD) risk according to a 2025 study published in Nature Cardiovascular Research. Among individuals who met the American Heart Association, European Society of Cardiology, and World Health Organization (AHA/ESC/WHO) guidelines of at least 150 minutes per week of moderate-to-vigorous physical activity, women with CHD experienced a threefold greater reduction in mortality risk compared with men.^[6]
   
   
7. Impact of lifestyle factors. Key lifestyle factors such as diet, exercise, smoking, and blood pressure have a greater negative impact on women’s heart health. Findings indicate that women were likely to have fewer risk factors and generally have better health than men, but when present, negative risk factors had a more pronounced increase in the risk of heart attack, stroke or other cardiovascular events.^[7]
   
   
8. Age-related risks. Women’s risk for cardiovascular disease rises with age. Factors that increase the risk of heart disease and stroke include reaching menopause before age 45, surgical removal of ovaries at an early age, declining levels of estrogen, sleep problems, increased abdominal fat, and increased cholesterol levels.^[8]
   
   
9. Lifestyle modifications can make a difference, even at midlife. A 2025 study documented that women’s heart health at menopause is a good predictor of overall health and wellness in their later years. The study, published in Menopause, focused on the shifts in heart health that occur at midlife and found that menopause is not only a time of increasing heart risk, but a juncture when women can still focus on their heart health and make a meaningful difference through improvements in diet, physical activity, nicotine exposure, sleep, body mass index, cholesterol, blood sugar, and blood pressure.^[9]
   
   
10. Need for gender-specific research. Cardiovascular disease develops and presents differently in women than in men, and the reasons behind sex and gender differences in cardiovascular disease are not completely understood. There is an ongoing gap in understanding the unique aspects of cardiovascular disease in women due to historical underrepresentation in research and clinical trials, which makes understanding the unique biology of their risk factors, symptoms and prevention/treatment a challenge.^[10] This underscores the need for more gender-specific studies to better address women’s health needs.
    
    

Talk to your female patients about heart health

As a health care provider, it’s vital to engage in conversations about heart health with female patients about preventive care, raise awareness of their specific risks, and create supportive care experiences. We invite you to read “Tips for enhancing women’s health experiences.”