Working to increase awareness of heart disease in women

NHLBI effort will reach out to younger women, Black and Latina women to reverse concerning trend 

Heart disease is the number one cause of death among women and men in the United States. Each year more than 300,000 women, or 1 in every 5, die from it. Yet, studies show that less than half of U.S. women are aware of the toll it can take, and even that percentage has been declining —from 65% in 2009 to about 44% in 2019, according to a 2021 study published in Circulation. 

Researchers and health educators — including those from the NHLBI — say while that trend is worrisome, they’re concerned that it’s mostly younger women and Black and Latina women whose awareness levels remain low. It’s why NHLBI is doubling down on current efforts to educate women about heart disease, with a new initiative from NHLBI’s The Heart Truth® program aimed especially at these groups. 

Neyal Ammary-Risch, M.P.H., team lead for Health Education & Research Dissemination in the NHLBI’s Office of Science Policy, Engagement, Education, and Communications, agreed. “For over a century, heart disease was unfortunately viewed by researchers and the public as a man’s disease. We’ve made a lot of progress over the years in raising awareness about women’s heart health, but younger women need our special focus. They don’t think heart disease is something they need to worry about until later in life, and that’s not true.” Nearly 75% of women ages 20-39 have one or more modifiable risk factors for heart disease, including diabetes, hypertension, high cholesterol, currently smoking, or have overweight or obesity, she noted.

In light of declining awareness, however, the program is adding a new promotional effort in late February called “Yes, YOU!” It is aimed at bringing awareness about heart disease to women in their 20s, 30s, and 40s, with a focus on Black and Latina women. These populations typically have higher rates of health conditions, such as high blood pressure, overweight and obesity, and diabetes, that increase the risk of heart disease. ”Yes,YOU!” will feature fact sheets, a video PSA, and social media resources to help inform and motivate those who may not know about their risks.

In addition to renewed outreach to these younger women and to women of color, Ammary-Risch said NHLBI is trying to boost heart-health literacy. “We’re increasing conversations on what causes heart disease, what are the risk factors, and how women can prevent it,” she said. “We want women to know that the choices they make now can reduce their risk through the rest of their life.”

“Awareness is the first step toward reducing risk,” said Gina S. Wei, M.D., M.P.H, associate director of NHLBI’s Division of Cardiovascular Sciences and NHLBI’s senior scientific advisor on women’s health. “Women need to be empowered to know the facts so they can take action to protect their hearts.” They can start, she said, by learning about how personal risk factors, such as high blood pressure, overweight or obesity, smoking, or even family history, can raise their chances of developing the disease. Then they can take action to minimize those risks. 

“Women can also take small steps, such as adding more physical activity to their day, adding an extra fruit or veggie to their meals, taking time to de-stress, and trying to get sufficient and quality sleep,” Wei said. These steps are especially helpful before, during, and after pregnancy, she explained, as heart problems that occur during pregnancy can impact the outcome of the delivery and also affect a woman’s heart years after she’s given birth. 

“So, it’s never too late or too early to start making your heart stronger,” Wei said. “It’s just a win-win for everybody.” 

Getting that message out in a way that makes a difference can be challenging, however. While researchers don’t know for sure what has accounted for the decline in awareness about heart disease among women, they say certain factors may play a role: a lack of screening tools to properly assess heart risk in younger age groups, inconsistent use of preventive care by women themselves, and misperceptions among young women that they are not at risk for heart disease. There’s also a dearth of education efforts that encourage heart-healthy behaviors specifically for women of color. The bottom line: more efforts have to be made to educate women through awareness campaigns, cardiovascular screening, and counseling, the researchers said.     

Heart disease is a catch-all phrase for a variety of conditions that affect the heart’s structure and how it works. The most common type in the U.S. is coronary heart disease, which develops when the arteries of the heart can’t deliver enough oxygen-rich blood to the heart. It is often caused by a buildup of cholesterol in the lining of the blood vessels. But it is highly preventable with a heart-healthy lifestyle and medications.

Symptoms of heart disease in women can vary, and they can differ from those that men have. Chest pain, heart palpitations, pain in the neck, jaw, or throat, and pain in the upper abdomen or back can all indicate heart disease. So can nausea, vomiting, excessive tiredness, or sleep problems. However, some women have no symptoms, and the first sign of heart disease can be a heart attack. Women who think they or a family member may have symptoms of heart disease should see a doctor right away, as early treatment can save lives.

Since 2002, the NHLBI has sponsored The Heart Truth®, a national health education program that raises awareness about heart disease. The program introduced the Red Dress as an iconic national symbol for women and heart disease to bring greater visibility to risk factors – such as obesity and high blood pressure – and motivate women to protect their hearts. The program, which targeted women ages 40-60, helped double awareness of heart disease in women after its initial launch. 

NHLBI continues to help spread awareness about heart disease in women through a variety of other special initiatives, including National Wear Red Day® (held the first Friday in February), in which people are encouraged to wear red clothing and share resources to motivate others to protect their hearts. It also celebrates American Heart Month throughout February by offering ideas for simple ways to incorporate heart-healthy actions into each day of the month. NHLBI also provides educational tools and resources to raise awareness of heart disease throughout the year.

Want to learn more about how women can improve their heart health? Visit these links to get specific tips on how to: 

• Eat a heart-healthy diet
• Increase physical activity
• Maintain a healthy weight
• Know and control your heart health numbers
• Get quality sleep
• Stop smoking
• Reduce stress

For more information on women and heart disease, visit: https://www.nhlbi.nih.gov/education/heart-truth/listen-to-your-heart