Risk Factors for Heart Disease
Women's risk factors for CHD differ in several important respects from men's.

Cholesterol. Studies have shown that women with high cholesterol levels have a somewhat lower mortality rate due to CHD than men with high cholesterol levels. High cholesterol levels may be less important than high levels of triglycerides in determining women's risk of CHD. For women in particular, high levels of HDL-cholesterol were associated with a low risk of developing CHD.

Triglycerides. High levels of triglycerides (the form in which most fat exists in the body) were more strongly associated with developing heart disease in women than in men.

High blood pressure. Doctors think that high blood pressure may be an even stronger predictor of CHD in women than it is in men.

Smoking. Smoking is worse for women than it is for men.

Overweight and obesity. Some scientists think that a person's hip-to-waist ratio (the amount of abdominal fat present) is a more important determinant for CHD than their body mass index. This is true for both men and women.

Diabetes. Women with diabetes have more than double the risk of heart attack of nondiabetic women.

Stress. Mental stress, along with depression (which affects twice as many women as men) have a worse effect on women's hearts than on men's.

Alcohol. Light-to-moderate consumption of alcohol (one drink a day) has been found to reduce the incidence of heart disease in women. But heavier drinking (more than two drinks a day) actually harms the heart, and may injure a woman's microvasculature (smaller blood vessels) at menopause, when she loses the protective effect of estrogen.

Oral contraceptives. Birth control pills raise blood pressure and increase the risk of a heart attack in women who smoke.

Lack of exercise. Sedentary women have twice the risk of CHD as active women.

Aging. Low levels of estrogen are a significant risk factor for developing cardiovascular disease in smaller blood vessels (microvascular disease). After menopause, the heart-protective effect of estrogen is lost. Heart disease is the leading cause of death and disability in women over 50.

Genetics. A family history of heart attack or CHD at a young age is a strong predictor of CHD.

Genetics
Not all risk factors for heart disease are controllable. Genetics are involved in increasing the likelihood of developing important risk factors, such as diabetes, high blood pressure, and high cholesterol levels. For instance, one genetic variant named apolipoprotein E4 (ApoE4) affects cholesterol levels, especially those associated with heart disease. Some people who have a genetic predisposition for high cholesterol levels absorb 90% of the cholesterol in the food they eat, while people who don't have this genetic factor absorb only 20%. This helps to explain why some people eat a high-fat diet and have low cholesterol levels, while others have persistently high cholesterol levels, even on a low-fat diet.

More on this topic

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Women's Symptoms
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Treatment
Prevention
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