Women and Heart Disease: Understanding the Risks

Cigarette and cigar in ashtray.

Risk factors are habits and conditions that make heart disease more likely. The more you have, the higher your chances of heart attack, also known as acute myocardial infarction, or AMI, and other problems. You can manage most risk factors to help make your heart healthier. Below are factors that increase your risk for having heart disease.


This is the most important risk factor you can change. Smoking causes inflammation and damages the smooth muscle that lines the arteries making them less flexible. It also raises your blood pressure, causing further damage to the artery lining. Smoking also increased your risk that your blood may clot, block an artery, and lead to a heart attack or stroke. Smoking also damages your lungs, which can affect the delivery of oxygen to the body. Research shows that smoking makes women up to 6 times more likely to have a heart attack. It's also important to avoid secondhand smoke (smoke from other people’s tobacco products). If you smoke, it's never too late to improve your heart. Ask your doctor about nicotine replacement products and smoking cessation counseling.


Diabetes causes high blood sugar, which can damage blood vessels if not kept under control. Having diabetes also makes you more likely to have a silent heart attack—one without any symptoms. This occurs because long periods of high sugar levels in your blood eventually degrade nerve conduction which reduces your sensation. This translates to decreased chest pain than would be felt in a person without diabetes during a heart attack. You’re at risk if your blood sugar level is above 100 mg/dL.

High cholesterol

Cholesterol is a fat-like substance in your blood. It can build up along the artery walls. This is called plaque. Over time, plaque narrows the arteries and reduces blood flow to your heart or brain. If a blood clot forms or a piece of the plaque breaks off, it can completely block the artery and cause a heart attack or stroke. Your risk of heart disease goes up if you have high levels of LDL ("bad") cholesterol or triglycerides (another fatty substance that can build up). You’re also at risk if you have low HDL cholesterol ("good") cholesterol. HDL helps clear the bad cholesterol away. You’re at risk if you have:  HDL cholesterol 50 mg/dL or lower; LDL cholesterol 100 mg/dL or higher; triglycerides of 150 mg/dL or higher.

High blood pressure

High blood pressure occurs when blood pushes too hard against artery walls. This causes damage to the artery walls and then the formation of scar tissue as it heals. This makes the arteries stiff and weak. Plaque sticks to the scarred tissue narrowing and hardening the arteries. High blood pressure also causes your heart to work harder to get blood out to the body. High blood pressure raises your risk of heart attack, also known as acute myocardial infarction, or AMI, and especially stroke. The brain tissue is especially sensitive to high blood pressure damage. You’re at risk if your blood pressure is 120/80 or higher.

Excess weight

Excess weight makes your heart work harder. This raises your risk of a heart attack. Being overweight also puts you at risk of developing diabetes and high blood pressure. Excess weight around the waist or stomach increases your risk the most. Being obese puts you at risk for developing heart disease.

Lack of exercise

Without regular exercise, you’re more likely to develop other risk factors, such as being overweight and developing diabetes. High blood pressure and unhealthy lipid levels are also more likely. Exercise promotes good blood flow and ensures your heart is able to meet the demands placed on it.

Negative emotions

Emotions such as stress and pent-up anger have been linked to heart disease. Over time, these emotions could raise your heart disease risk. If you have heart disease, emotion such as anxiety and depression can make it worse. Managing these emotions is important as they have been shown to reduce hormones that increase stress on the heart in the long run.

Metabolic syndrome

This is caused by a combination of certain risk factors. It puts you at extra high risk of heart disease, stroke, and diabetes. You have metabolic syndrome if you have 3 or more of the following: low HDL cholesterol; high triglycerides; high blood pressure; high blood sugar; extra weight around the waist.

Risks you can’t control

A few risk factors can’t be changed. But they still raise your heart disease risk.

  • Family history. If your mother or sister had heart trouble before age 65 or your father or brother before age 55, you’re at higher risk of having a heart attack.

  • Age. The older you are, the higher your heart disease risk.


For more information

  • www.smokefree.gov/talk-to-an-expert

  • www.women.smokefree.gov

  • National Cancer Institute Smoking Quitline: 877-44U-QUIT (877-448-7848)