Women and heart disease | Heart and Stroke Foundation

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

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.
• Gender-affirming hormone therapy puts trans women at increased risk for stroke, blood clots and heart attacks.
• Ninety percent of all SCAD cases are women (spontaneous coronary artery dissection).
• Women are less likely than 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.
• Indigenous people in Canada are more likely to be at risk for or currently living with heart disease and stroke compared to the general population. 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.

Indigenous women and heart disease 

Indigenous people in Canada are more likely to be at risk for or currently living with heart disease and stroke compared to the general population.  For some Indigenous groups, the death rate from heart disease and stroke is also higher, particularly for women and younger age groups.

• The lifetime risk and prevalence of diabetes is higher in Indigenous people compared to the general population of Canada — particularly for women.
• Accessing care is difficult. Some communities don’t have emergency services and people with complex needs may have to leave their communities to get specialized care.
• Indigenous people face discrimination and mistreatment within the healthcare system. As a result, they’re much less likely to seek care — and much more likely to get misdiagnosed if they do.

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) 

Women’s unique risk factors  

Talking to your doctor

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