Women and heart disease

Three women sitting on a bench engaged in conversation.

Women’s experience with heart disease is different from men’s in several important ways.

Women are under-aware and under-researched. Within the healthcare system they are under-diagnosed and under-treated, and under-supported in their recovery. Women’s unique physiology poses distinct challenges in the prevention and management of heart disease.

For women’s heart health to improve, the healthcare system needs to catch up to the fact that women’s hearts are different – and ensure that  new knowledge about women and heart disease is translated into better prevention, diagnosis and treatment.

At the same time, women need to inform and empower themselves – and take personal responsibility for their heart health. 

The differences between men and women with heart disease
  • Women’s heart disease tends to appear in the smaller, blood vessels of the heart (microvascular disease) rather than the major coronary arteries. This means that their symptoms might not fit the classic textbook picture of heart disease. Women are more likely to experience chest discomfort (rather than a crushing pain), shortness of breath, fatigue, indigestion or nausea, back or neck pain.  
  • Angiograms are not effective at diagnosing microvascular disease. Stress tests are also less sensitive for women.
  • Women are less likely to be prescribed needed drugs such as blood pressure or cholesterol-lowering medication after a heart attack.
  • Women’s hearts are impacted by pregnancy, menopause and hormonal changes throughout their lives.
  • Ninety percent of all SCAD cases are women (spontaneous coronary artery dissection).
  • Women are only half as likely as men to attend cardiac rehabilitation programs after a heart attack. Cardiac rehab is key to preventing a second heart attack and people who complete a program have better functional ability, quality of life and experience less depression.
  • Coronary heart disease is responsible for a 53% higher death rate in Indigenous women compared to non-Indigenous women. The issues many Indigenous communities face regarding access to health care, education, and affordable food and water influence heart health.
  • Women of South Asian, Chinese and Afro-Caribbean descent have higher rates of heart disease. They also have more high blood pressure and diabetes, but lower levels of physical activity.

 The Heart & Stroke 2018 Heart Report  takes a hard look at these “unders” — how we got here, and how we can work together to close the gaps that put too many women at risk. The risks are even higher for Indigenous and ethnically diverse women, women living in poverty and women in remote and rural areas. 

Explore more information and support for  Women

Indigenous women and heart disease 

Trauma through the generations and high-stress environments created by the impacts of historical policies have contributed to higher levels of heart disease in Indigenous women.

  • Indigenous communities in Canada often face challenges to good health including lack of access to health care, affordable food and safe drinking water, and other factors.
  • Indigenous people in Canada are two times more likely to develop heart disease than non-Indigenous Canadians.
  • Coronary heart disease is responsible for a 53% higher death rate in Indigenous women compared to non-Indigenous women.
  • Indigenous women die from heart disease at a younger age compared to non-Indigenous women. 
Sex and gender: What’s the difference?

Sex and gender are different, and both affect women’s health. Here’s how the Canadian Institutes for Health Research explains the two terms:

  • Sex refers to the biology of humans and animals, including physical features, chromosomes, gene expression, hormones and anatomy.
  • Gender is the social roles, behaviours, expressions and identities of girls, women, boys, men and gender diverse people.
Related information 

The Beat: We can heal more women (podcast)

Read the 2020 Spotlight on Women

Women’s unique risk factors  

Talking to your doctor

Get healthy

Esther’s story: A healing combination