February is Heart Month

Hearts are often the symbol of love and romance, especially for women but we need to recognize that this organ is vital for wellness, and we should recognize women’s particular vulnerabilities in heart health.

President Lyndon B. Johnson declared February to be American Heart Month in 1964 to raise awareness about heart disease and promote education, illness prevention, and support for research into cardiovascular diseases. It began as a call across the nation for people to take charge of personal heart health and to learn basic cardiopulmonary resuscitation, known as CPR. Over half of adults in the United States are not aware that heart disease is the leading cause of death for both men and women in this country and has been since 1921 according to the Centers for Disease Control and Prevention (CDC). Despite awareness campaigns over the past hundred years, we still bury our heads in the sand since many cardiovascular illnesses, such as hypertension (high blood pressure) do not have readily felt symptoms.

The most recent data set we have is for 2022, when 941,652 deaths were caused by cardiovascular disease. Heart disease and strokes caused more deaths that all cancers and lower respiratory tract diseases combined. But these sad statistics are unfortunately not getting better. According to the 2025 Heart Disease and Stroke Statistics: A Report of U.S. and Global Data from the American Heart Association, 48.6% of people in the U.S have some sort of cardiovascular disease (CVD) including hypertension, heart failure, coronary heart disease and stroke.

We have had many advancements in research but still there are gaps in the diagnosis and treatment of cardiovascular diseases in women. Janet Wei, M.D., is an associate professor of cardiology and biomedical sciences at Cedars-Sinai Medical Center in Los Angeles. “Most women still do not recognize that heart disease is the leading cause of death,” she said in an interview with the online medical newsletter Healio, Feb. 5. She noted that there needs to be more sex-specific research. Past studies have shown that women’s normal blood pressure range might be lower than men’s normal blood pressure range and his could put women at a higher risk for heart attack or stroke than men. Also risk factors such as hypertension and high cholesterol are still generally undertreated in women. Due to the protective effect of the hormone estrogen, women usually present with heart disease about 10 years later than men. Broad risk scores that are used to estimate cardiovascular risks over the following 10 years usually indicate that women under 60 have a low risk but some sex-specific conditions — such as a history of preeclampsia (a multisystem disorder that can arise after 20 weeks of pregnancy with high blood pressure and protein in urine that can lead to organ damage and seizures), autoimmune diseases and early menopause — are associated with a higher risk for CVD. Well-known risk factors such as obesity and diabetes increase the heart disease risk more in women than men.

Angina is chest discomfort, usually caused by a reduced flow of blood to the heart. When women experience chest pain they are often dismissed more than if they were men when the testing shows no coronary artery obstructions. Dr. Wei’s research team at Cedars-Sinai studies coronary microvascular dysfunction and coronary vasospasm. This is when a coronary artery spasms, leading to the blood vessel constricting and lessening the blood flow which can cause tissues to go without a good blood supply (ischemia). This is painful and often the precursor to a heart attack, heart failure and ischemic heart disease. Vasospasm is more prevalent in women than men.

Cardiovascular-kidney-metabolic syndrome (CKM) is a recently named health condition that includes heart disease, kidney disease, diabetes, and obesity. According to the American Heart Association, 89 million people are at risk of developing CKM syndrome in the United States. While new therapies are being developed, many people currently receive fragmented care without treating the syndrome rather than individual components. This will invariably lead to poor health outcomes. CKM syndrome affects more women than men. It is unclear how adipose (fat) tissue affects women differently than men and postmenopausal women generally have excess inflammatory adipose tissue. Research is needed to understand the sex differences in the pathophysiology of CKM syndrome so individually tailored treatment can be offered.

Another major concern for women’s heart health is the high maternal mortality rate in the United States, the highest among wealthy first world countries. CVD is the leading cause of death in pregnant and postpartum women. Seventy-five percent of these deaths are preventable with adequate prenatal care and the recognition of cardiac symptoms. Though many pregnant women experience increased fatigue, swollen legs and feet, or shortness of breath, these symptoms should warrant a cardiac evaluation to avoid the development of preeclampsia, stroke, or heart failure. Pregnancy can be considered a woman’s first heart stress test. How her heart adapts to the pregnancy can predict possible future cardiovascular health.

Women’s heart health is also impacted by chronic stress, depression, and anxiety. The mind-body connection is strong, and stress hormones can increase blood pressure, vasoconstriction, and inflammation. Chronic stress, anxiety and depression can also lead to poor sleep, less than healthy diet, and decreased physical activity. All this can increase the risk for heart attack and stroke by 30% to 40%. Positive mental health qualities such as optimism and a sense of purpose are associated with a lower cardiovascular risk.

Cardiovascular screening should include blood pressure check and blood tests for diabetes (and prediabetes) and cholesterol by age 20. Awareness of family history is important and should be considered when the 30-year risk assessment is determined. If a woman has a low short-term risk, she should be reevaluated at age 30 to determine a risk for CVD and heart failure.

A message for the month of love is to be aware of your heart health. Knowledge of risks is that essential step in preventing and treating heart disease.