Heart disease is often thought to be more of a problem for men. However, it's the most common cause of death for both women and men in the United States. Because some heart disease symptoms in women can differ from those in men, women often don't know what to look for.

Fortunately, by learning their unique heart disease symptoms, women can begin to reduce their risks.

Heart attack symptoms for women

The most common heart attack symptom in women is the same as in men – some type of chest pain, pressure or discomfort that lasts more than a few minutes or comes and goes. But chest pain is not always severe or even the most noticeable symptom, particularly in women. Women often describe it as pressure or tightness. And, it's possible to have a heart attack without chest pain.

Women are more likely than men to have heart attack symptoms unrelated to chest pain, such as:

• Neck, jaw, shoulder, upper back or abdominal discomfort
• Shortness of breath
• Pain in one or both arms
• Nausea or vomiting
• Sweating
• Lightheadedness or dizziness
• Unusual fatigue
• Indigestion

These symptoms may be vague and not as noticeable as the crushing chest pain often associated with heart attacks. This might be because women tend to have blockages not only in their main arteries but also in the smaller ones that supply blood to the heart — a condition called small vessel heart disease or coronary microvascular disease.

Women tend to have symptoms more often when resting, or even when asleep, than they do in men. Emotional stress can play a role in triggering heart attack symptoms in women.

Because women don't always recognize their symptoms as those of a heart attack, they tend to show up in emergency rooms after heart damage has occurred. Also, because their symptoms often differ from men's, women might be diagnosed less often with heart disease than men are.

If you have symptoms of a heart attack or think you're having one, call for emergency medical help immediately. Don't drive yourself to the emergency room unless you have no other options.

Heart disease risk factors for women

Several traditional risk factors for coronary artery disease — such as high cholesterol, high blood pressure and obesity — affect both women and men. But other factors can play a bigger role in the development of heart disease in women.

Heart disease risk factors for women include:

• Diabetes. Women with diabetes are more likely to develop heart disease than are men with diabetes. Also, because diabetes can change the way you feel pain, you're at greater risk of having a silent heart attack — without symptoms.
• Mental stress and depression. Stress and depression affect women's hearts more than men's. Depression makes it difficult to maintain a healthy lifestyle and follow recommended treatment.
• Smoking. Smoking is a greater risk factor for heart disease in women than it is in men.
• Inactivity. A lack of physical activity is a major risk factor for heart disease. Some research has found women to be less active than men.
• Menopause. Low levels of estrogen after menopause pose a significant risk of developing disease in smaller blood vessels.
• Pregnancy complications. High blood pressure or diabetes during pregnancy can increase the mother's long-term risk of high blood pressure and diabetes. The conditions also make women more likely to get heart disease.
• Family history of early heart disease. This appears to be a greater risk factor in women than in men.
• Inflammatory diseases. Rheumatoid arthritis, lupus and others can increase the risk of heart disease in both men and women.

Is heart disease something only older women should worry about?

No. Women of all ages should take heart disease seriously. Women under age 65 — especially those with a family history of heart disease — also need to pay close attention to heart disease risk factors.

What can women do to reduce their risk of heart disease?

Living a healthy lifestyle can help reduce the risk of heart disease. Try these heart-healthy strategies:

• Quit smoking. If you don't smoke, don't start. Try to avoid exposure to secondhand smoke, which also can damage blood vessels.
• Exercise regularly. In general, everybody should do moderate exercise, such as walking at a brisk pace, on most days of the week.
• Maintain a healthy weight. Ask your health care provider what weight is best for you. If you're overweight, losing even a few pounds can lower blood pressure and reduce the risk of diabetes.
• Eat a healthy diet. Opt for whole grains, a variety of fruits and vegetables, low-fat or fat-free dairy products, and lean meats. Avoid saturated or trans fats, added sugars, and high amounts of salt.
• Manage your stress. Stress can cause your arteries to tighten, which can increase your risk of heart disease, particularly coronary microvascular disease.
• Limit alcohol. If you have more than one drink a day, cut back. One drink is approximately 12 ounces (360 milliliters) of beer, 5 ounces (150 milliliters) of wine or 1.5 ounces (45 milliliters) of distilled spirits, such as vodka or whiskey.
• Follow your treatment plan.Take your medications as prescribed, such as blood pressure medications, blood thinners and aspirin.
• Manage other health conditions. High blood pressure, high cholesterol and diabetes increase the risk of heart disease.

Exercise to reduce the risk of heart disease in women

The Department of Health and Human Services recommends at least 150 minutes a week of moderate aerobic activity, 75 minutes of vigorous aerobic activity a week, or a combination of the two.

That's about 30 minutes a day, five days a week. If that's more than you can do, start slowly and build up. Even five minutes a day of exercise has health benefits.

For a bigger health boost, aim for about 60 minutes of moderate to vigorous exercise a day, five days a week. Also do strength training exercises two or more days a week.

It's OK to break up your workouts into several 10-minute sessions during a day. You'll still get the same heart-health benefits.

Interval training — in which you alternate short bursts of intense activity with intervals of lighter activity — is another way to maintain a healthy weight, improve blood pressure and keep your heart healthy. For example, include short bursts of jogging or fast walking into your regular walks.

You can also add exercise to your daily activities with these tips.

• Take the stairs instead of an elevator.
• Walk or ride your bike to work or to do errands.
• March in place while watching television.

What's a healthy weight?

What's considered a healthy weight varies from person to person, but having a normal body mass index (BMI) is helpful. BMI is a measurement of body fat calculated from height and weight. A BMI of 25 or higher can be associated with an increased risk of heart disease.

Your waist measurement (waist circumference) also is a useful tool to tell whether or not you're overweight. Women are generally considered overweight if their waist measurement is greater than 35 inches (89 centimeters).

Is the treatment for heart disease in women different than in men?

In general, heart disease treatment in women and in men is similar. It can include medications, angioplasty and stenting, or coronary bypass surgery.

Women are less likely to be prescribed statin therapy to prevent future heart attacks than are men. However, studies show the benefits are similar in both groups. Angioplasty and stenting, commonly used treatments for heart attack, work for both men and women. But for coronary bypass surgery, women are more likely than men to have complications.

Cardiac rehabilitation can improve health and aid recovery from heart disease. However, women are less likely to be referred for cardiac rehabilitation than men are.

Taking aspirin to prevent heart disease in women

If you've had a heart attack, your health care provider might recommend that you take low-dose aspirin every day to help prevent another. But aspirin can increase the risk for bleeding. Therefore, daily aspirin therapy isn't recommended for women who've never had a heart attack.

Never start taking aspirin for heart disease prevention on your own. Talk with your health care provider about your risks and benefits of taking aspirin.

This article is written by Mayo Clinic Staff. More health and medical information can be found on mayoclinic.org.

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