Heart disease continues to be the leading cause of death among women in the United States. Experts at NYU Langone Health’s Leon H. Charney Division of Cardiology say that awareness of cardiovascular risk, especially among younger women and women of color, has not improved in recent years, despite rising rates of high blood pressure, diabetes, obesity, and high cholesterol. They emphasize the importance of earlier screening, more effective prevention strategies, and education about heart disease types that affect women more than men.
During Heart Health Month, NYU Langone cardiologists Harmony R. Reynolds, MD; Anaïs Hausvater, MD; Shaline D. Rao, MD; Doris Chan, DO; and Nathaniel R. Smilowitz, MD are highlighting key issues for women’s heart health throughout different stages of life—including pregnancy and menopause—as well as developments in therapies and technology.
Cardiovascular care for women is advancing with new diagnostic tools and treatments. NYU Langone Heart is expanding specialized services such as the Cardio-Obstetrics Program and using multidisciplinary approaches to tailor care more precisely to each woman’s needs.
Dr. Hausvater described pregnancy as “nature’s stress test,” noting that it puts significant demands on the heart: “Blood volume increases, the heart rate rises, and the heart has to work significantly harder.” She explained that complications like preeclampsia or gestational diabetes during pregnancy are now recognized as long-term risk markers for cardiovascular disease: “These risks don’t disappear after delivery,” she said. “Even 30 to 40 years later, we see higher rates of heart disease, heart failure, and stroke.”
Dr. Reynolds added that many factors specific to women—such as early menopause or certain reproductive conditions—should be considered in risk assessments: “There’s growing evidence linking early menopause, breast cancer treatments, fibroids, endometriosis, polycystic ovary syndrome, autoimmune disease, miscarriages, and pregnancy complications to cardiovascular disease,” she said. “We need to bring these factors into everyday clinical conversations so women receive more personalized risk assessments.”
Menopause marks a critical period for reassessing cardiovascular risk due to rises in cholesterol and blood pressure levels: “This is a critical window to reassess heart risk and intervene early,” Dr. Hausvater noted.
Symptoms of heart disease can also differ between men and women. According to Dr. Reynolds: “Younger women don’t always present with classic blocked-artery heart attacks…They may develop artery spasms, small-vessel disease or spontaneous coronary artery dissection—what we often describe as a ‘bruise in the artery wall.’” These conditions can lead to delays in diagnosis because symptoms may be mistaken for anxiety or gastrointestinal problems rather than cardiac issues.
Dr. Chan highlighted the importance of recognizing these less typical presentations: “These patients don’t fit the traditional heart disease profile,” she said.
Women are also more likely than men to experience a type of heart failure where the pumping function appears normal but relaxation is impaired (heart failure with preserved ejection fraction). Dr. Rao stated: “But many women develop heart failure where the heart looks normal on imaging yet symptoms such as fatigue and shortness of breath can be just as serious.” She noted improvements from newer therapies alongside benefits from cardiac rehabilitation programs.
The use of wearable devices like smartwatches is helping detect abnormal rhythms or other potential problems earlier than before. Dr. Smilowitz remarked: “These tools can absolutely save lives.” However, Dr. Hausvater cautioned against relying solely on data from devices without expert guidance: “Too much data without guidance can increase anxiety…The key is pairing technology with expert care.”
Specialized testing at NYU Langone helps clarify cases when routine scans do not reveal clear answers about ongoing symptoms.
Despite proven safety records for statin medications—which reduce risks by lowering cholesterol levels—many eligible women still do not receive them or are hesitant due to misinformation.“Statins are one of the most powerful tools we have to reduce heart attack and stroke risk,” said Dr. Chan.
GLP-1 medications such as Ozempic are also being used more widely for cardiovascular prevention but should not replace established preventive measures according to Dr.Rao:“These therapies can significantly improve blood pressure,cholesterol,and metabolic health…but they should complement prevention—not replace it.”
NYU Langone experts encourage all women not only to prioritize prevention but also seek early detection efforts tailored specifically for them.“Women’s heart disease is not one-size-fits-all,” said Dr.Reynolds.“Understanding these differences—and acting on them early—can save lives.”
