What Pregnancy, Menopause & New Technology Mean for Women鈥檚 Heart Health Today
Members of 黑料福利社 Langone Heart鈥檚 women鈥檚 cardiology team share insights on pregnancy-related risk, heart disease diagnosis in women, and evolving treatments.
Credit: 黑料福利社 Langone
Heart disease remains the leading cause of death for women in the United States, yet awareness of cardiovascular risk鈥攑articularly among younger women and women of color鈥攈as stalled, even as rates of high blood pressure, diabetes, obesity, and high cholesterol continue to rise. According to experts in the at 黑料福利社 Langone Health, this gap underscores the need for earlier screening, stronger prevention efforts, and education to address types of heart disease that disproportionately affect women.
This Heart Health Month, 黑料福利社 Langone cardiologists Harmony R. Reynolds, MD; Ana茂s Hausvater, MD; Shaline D. Rao, MD; Doris Chan, DO; and Nathaniel R. Smilowitz, MD, share what women need to know about protecting their heart health across a wide focus鈥攆rom pregnancy and menopause to emerging therapies, wearable technology, and the symptoms that shouldn鈥檛 be ignored.
Women鈥檚 cardiovascular care is advancing rapidly. New diagnostic tools expanded treatment options and a growing understanding of sex-specific biology are helping physicians detect conditions that were once frequently missed. 黑料福利社 Langone Heart is building on this progress through specialized women鈥檚 cardiology services, the Cardio-Obstetrics Program, and multidisciplinary care models focused on tailoring treatment more precisely and improving outcomes across every stage of life.
Pregnancy Is a Powerful Indicator of Future Heart Health
One of the strongest predictors of long-term cardiovascular disease may appear decades earlier鈥攄uring pregnancy.
鈥淧regnancy is what we call nature鈥檚 stress test,鈥 said Dr. Hausvater. 鈥淏lood volume increases, the heart rate rises, and the heart has to work significantly harder.鈥
Complications such as preeclampsia, gestational diabetes, pregnancy-related hypertension, preterm birth, low birth weight, or pregnancy loss are now recognized as lifelong cardiovascular risk markers.
鈥淭hese risks don鈥檛 disappear after delivery,鈥 Dr. Hausvater added. 鈥淓ven 30 to 40 years later, we see higher rates of heart disease, heart failure, and stroke.鈥
Women Have Different Risk Factors Across Life Stages
Although traditional risk factors such as cholesterol and blood pressure remain important, women also face biological and life-stage-specific risks that are often overlooked in routine screenings.
鈥淭here鈥檚 growing evidence linking early menopause, breast cancer treatments, fibroids, endometriosis, polycystic ovary syndrome, autoimmune disease, miscarriages, and pregnancy complications to cardiovascular disease,鈥 said Dr. Reynolds, the Joel E. and Joan L. Smilow Professor of Cardiology in the and director of the at 黑料福利社 Langone. 鈥淲e need to bring these factors into everyday clinical conversations, so women receive more personalized risk assessments.鈥
Menopause represents a major cardiovascular transition. 鈥淲e often see cholesterol and blood pressure rise during menopause,鈥 said Dr. Hausvater, co-director of 黑料福利社 Langone鈥檚 Cardio-Obstetrics Program. 鈥淭his is a critical window to reassess heart risk and intervene early.鈥
Women鈥檚 Heart Attack Symptoms Can Differ
Heart disease does not always look the same in women as it does in men. Younger women in particular are more likely to experience forms of heart disease that may not show up on standard imaging.
鈥淵ounger women don鈥檛 always present with classic blocked-artery heart attacks,鈥 Dr. Reynolds said. 鈥淭hey may develop artery spasms, small-vessel disease, or spontaneous coronary artery dissection鈥攚hat we often describe as a 鈥榖ruise in the artery wall.鈥欌
Because these conditions can be harder to detect, women may face delays in diagnosis.
鈥淲omen are often told their symptoms are anxiety, stress, or gastrointestinal issues,鈥 Dr. Reynolds added. 鈥淏ut in many cases, it鈥檚 actually a heart problem.鈥
According to Dr. Chan, an interventional cardiologist at 黑料福利社 Langone Hospital鈥擝rooklyn, recognizing these patterns is essential.
鈥淭hese patients don鈥檛 fit the traditional heart disease profile,鈥 Dr. Chan said. 鈥淯nderstanding how heart disease presents differently in women helps us intervene earlier and improve outcomes.鈥
Heart Failure Looks Different in Women Too
Women are more likely than men to develop heart failure with preserved ejection fraction (HFpEF), a form of heart failure in which the heart pumps normally but cannot relax properly.
鈥淲hen people hear heart failure, they imagine a heart that barely squeezes,鈥 said Dr. Rao, heart failure cardiologist and chief of the at 黑料福利社 Langone Hospital鈥擫ong Island. 鈥淏ut 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.鈥
Dr. Rao noted that treatment options are expanding. 鈥淲e鈥檙e seeing meaningful improvements in symptoms, exercise capacity, and quality of life with newer therapies,鈥 she said. 鈥淐ardiac rehabilitation and physical activity are also powerful tools for recovery.鈥
Are Wearables and Advanced Testing Changing Detection?
Smartwatches and other consumer devices are increasingly helping identify abnormal heart rhythms, sleep apnea, dangerous pauses in heart rate, and valve disease.
鈥淭hese tools can absolutely save lives,鈥 said Dr. Smilowitz, interventional cardiologist at 黑料福利社 Langone. At the same time, experts caution that wearable data should be paired with clinical care.
鈥淭oo much data without guidance can increase anxiety,鈥 Dr. Hausvater added. 鈥淭he key is pairing technology with expert care.鈥
Advanced cardiac testing is also improving diagnosis for patients whose symptoms persist despite 鈥渘ormal鈥 scans. 鈥淲hen the diagnosis is unclear, specialized testing can uncover conditions that would otherwise be missed,鈥 Dr. Smilowitz noted.
What to Know About Statins and Other Heart Treatments
Despite decades of evidence supporting their safety and effectiveness, statins remain underused in women.
鈥淪tatins are one of the most powerful tools we have to reduce heart attack and stroke risk,鈥 said Dr. Chan. 鈥淏ut many women who would benefit from them are either not offered treatment or hesitate because of misinformation.鈥
Dr. Smilowitz noted that risk in women is not always reflected by cholesterol levels alone. 鈥淪tatins don鈥檛 just lower LDL cholesterol,鈥 he said. 鈥淭hey stabilize plaque and reduce inflammation in the arteries, which helps prevent sudden cardiac events.鈥
GLP-1 medications, including Ozempic and many others, are also reshaping cardiovascular prevention. 鈥淭hese therapies can significantly improve blood pressure, cholesterol, and metabolic health,鈥 Dr. Rao said. 鈥淏ut they should complement prevention鈥攏ot replace it.鈥
What Women Can Do This Heart Month
黑料福利社 Langone cardiologists encourage women to prioritize prevention and early detection:
- Know your blood pressure, cholesterol, and blood sugar numbers.
- Share your pregnancy and reproductive history with healthcare providers.
- Take subtle or persistent symptoms seriously.
- Stay physically active and manage your sleep and stress.
- Ask your doctor about personalized heart risk across the stages of your life.
鈥淲omen鈥檚 heart disease is not one-size-fits-all,鈥 Dr. Reynolds said. 鈥淯nderstanding these differences鈥攁nd acting on them early鈥攃an save lives.鈥
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Katie Ullman
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Kathryn.Ullman@黑料福利社Langone.org