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High blood pressure

High blood pressure, also called hypertension, raises your risk for heart disease. Blood pressure is the force your blood makes against your artery walls when your heart beats. If this force (pressure) is too high, it can damage your heart over time.

Your risk for high blood pressure goes up as you age. Two out of every 3 women 60 and older have high blood pressure.1

You are also more likely to have high blood pressure if you have a family history of high blood pressure. Other risk factors for high blood pressure include eating unhealthy food often, not exercising, and being overweight.

In the United States, African-American women are at the highest risk for high blood pressure. This may be because African-American women are more likely to be obese or have diabetes, which can cause high blood pressure. Research has also found a gene common in African-Americans that increases sensitivity to salt. In people who have this gene, just one extra half a teaspoon of salt a day could raise blood pressure.2  Also, studies show that blood pressure levels are higher among African-Americans in the United States even after controlling for other health factors, and some of the difference is likely due to the effects of discrimination.3

Many women — more than men — get "white coat hypertension." This means that your anxiety or stress level goes up when you are at the doctor's office, and this can make your blood pressure go up. If medical visits increase your anxiety level, ask your doctor for a monitor to wear at home to get a more accurate blood pressure reading.

High blood pressure does not usually have symptoms. The only way to know you have it is to get your blood pressure measured. Measure your blood pressure to find out your numbers:

  • Systolic (siss-TOL-ihk) (the first or top number) is the pressure as your heart beats or pumps blood into your arteries.
  • Diastolic (deye-uh-STOL-ihk) (the second or bottom number) is the pressure when your heart is at rest.

To lower your risk for heart disease, try to lower your blood pressure levels to less than 120 systolic/80 diastolic. To lower your blood pressure:

  1. Lose weight if you are overweight.
  2. Get at least 30 minutes of physical activity most days.
  3. Don't smoke.
  4. Eat healthy.
  5. Lower sodium in your diet.
  6. Don't drink alcohol, or drink only in moderation.
  7. Take blood pressure medicine if your doctor prescribes it.

Learn more about high blood pressure.

High cholesterol and triglycerides

Cholesterol is a waxy, fat-like substance that is found in all cells of your body. Your body makes all the cholesterol you need. You also get cholesterol and saturated fat from food such as meat and dairy products. Fruits and vegetables do not have any cholesterol or saturated fat.

The extra fat from the foods you eat can clog your arteries. A blood test can measure your levels of:

  • Low-density lipoprotein (LDL) or "bad" cholesterol. High LDL levels lead to cholesterol buildup in arteries.
  • High-density lipoprotein (HDL) or "good" cholesterol. High HDL levels are actually good. HDL cholesterol helps lower the total cholesterol level in your body.
  • Total cholesterol. This is the total amount of cholesterol in your blood, including LDL cholesterol and HDL cholesterol.
  • Triglycerides. Triglycerides are another type of fat in your blood. High triglycerides may raise women's heart disease risk more than men's heart disease risk.

In women, high triglycerides combined with low HDL cholesterol can mean a very high risk of heart disease. There are no symptoms of high cholesterol or triglycerides. The only way to know whether you have high LDL or "bad" cholesterol or triglyceride levels is to see your doctor for a blood test. Your doctor can prescribe medicines and talk with you about changing your eating habits and getting more physical activity to help lower your cholesterol level.

Learn more about high cholesterol.

Overweight and obesity

The more overweight you are, the higher your risk of heart disease is. This is true even if you have no other risk factors.

Three out of every four women in the United States are overweight or obese. Women of all races and ethnicities are more likely to be obese than men of the same age, but women in some racial groups are more likely to be obese than others.4

Extra weight increases your heart disease risk in two main ways:                                                            

  • The extra pounds hurt your heart. Extra weight makes your body larger. The heart has to work harder to move blood around the body. Like an overworked pump, the hearts of overweight and obese people wear out more quickly.
  • Excess weight makes you more likely to develop other risk factors for heart disease, such as high blood pressure and diabetes.

To lower your risk for heart disease, your body mass index (BMI) should be between 18.5 and 24.9. A BMI between 25 and 29.9 is considered overweight. A BMI of 30 or higher is considered obese. Find your BMI using this BMI calculator from the Centers for Disease Control and Prevention.

Where you carry extra weight also affects your heart disease risk. Women who carry body fat around their waists (apple-shaped body) are at higher risk for heart disease than those who carry weight around their hips and thighs (pear-shaped body). Women with waist measurements more than 35 inches, regardless of their height, have a higher risk of heart disease.

An "apple-shaped" woman's body and a "pear-shaped" woman's body

Women with an apple-shaped body may have a higher risk for heart disease than women with a pear-shaped body.

Diabetes

Diabetes seriously raises your risk for heart disease and makes you less likely to survive a heart attack. This is true for women and men. But the number of men with diabetes who develop heart disease has gone down. The number of women with diabetes who develop heart disease has not gone down in recent years. Experts think this may be because of the link between heart disease, diabetes, and obesity, especially extra body fat that is carried around the waist. This link may be stronger for women, especially postmenopausal women, than for men.5 

Uncontrolled diabetes can damage your arteries and make you more likely to get high blood pressure and form blood clots that can cause a heart attack. About 28% of Americans with diabetes don't know that they have it.6 The only way to know for sure whether you have diabetes is to get a blood test.

Learn more at our diabetes page and learn about the link between diabetes and the risk for heart disease.

Metabolic syndrome

Metabolic (met-uh-BOL-ihk) syndrome is the name for a group of risk factors that happen together and are related to your metabolism. Metabolism is the process your body uses to convert food into energy. Having metabolic syndrome doubles your risk of heart disease. Metabolic syndrome is more common in women than men.7 You have metabolic syndrome if you have any three of these five risk factors:

  • Waist measurement of more than 35 inches
  • Triglyceride level greater than 150 mg/dL (milligrams per deciliter)
  • HDL cholesterol less than 50 mg/dL
  • Blood pressure of 130/85 mmHg (millimeters of mercury) or higher
  • Blood glucose greater than 110 mg/dL after fasting for at least eight hours

If you have metabolic syndrome, you can take steps to control your risk factors. Your doctor will do cholesterol, blood pressure, and blood glucose tests regularly to find out your risk for metabolic syndrome.

Learn more about metabolic syndrome.

Excessive blood clotting

Excessive, or extra, blood clotting is when blood clots form too easily or break apart too slowly. Blood clots can narrow arteries and veins or block blood flow completely. This can lead to heart attack, stroke, or damage to the kidneys, lungs, or other parts of the body.

Women of childbearing age (between 15 and 44) are at higher risk of blood clots than men of the same age.8,9 Your family health history, pregnancy, and certain medicines can cause excessive blood clotting. Medicines with the hormone estrogen, such as hormonal birth control or menopausal hormone therapy, can raise your risk for blood clots. Healthy everyday habits like healthy eating and physical activity can make clots less likely to form. Some people with excessive blood clotting may also need medicine to prevent clots.

Learn more about excessive blood clotting.

Lupus and rheumatoid arthritis

Lupus and rheumatoid arthritis are health problems that affect more women than men.10,11 Lupus and rheumatoid arthritis are autoimmune disorders. This means that they cause your immune system to attack the tissues and organs in your body, rather than just fighting off infections. Sometimes your heart and blood vessels are the tissues and organs that are attacked.

Treating your lupus or rheumatoid arthritis can lower your risk of heart disease.

Read more about lupus and rheumatoid arthritis.

Depression

Depression affects twice as many women as men.12 Also, research found that women 55 and younger who are depressed are twice as likely to have a heart attack or to die of heart disease as women who are not depressed.13 Depression also increases your risk for another heart attack if you've had one already. Depression can hurt your heart's ability to beat correctly. It also can speed up the buildup of plaque in your arteries.

Most people with depression get better with treatment, which may include therapy and medicine. Treating your depression can help lower your risk for heart disease. Learn more at our depression page, and read more about the link between depression and heart disease.

Sleep apnea

Loud snoring is often a sign of sleep apnea (AP-nee-uh). Sleep apnea is a common sleep disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.

Sleep apnea is linked to atrial fibrillation (irregular heartbeat). Sleep apnea also may affect more than half of people with heart disease.14

With obstructive sleep apnea, the most common type, the tissue in the back of the throat relaxes. This blocks airflow to your lungs and lowers the oxygen level in your blood. Your heart must work harder to pump blood through your body. This raises your risk for high blood pressure, heart attack, and stroke.

Women with sleep apnea may have different symptoms than men. The most common symptom of sleep apnea in men is loud snoring. While women may also have snoring, they may have insomnia, morning headaches, or sleepiness instead. These symptoms can be mistaken for other health problems.

If you think you might have sleep apnea, talk to your doctor. Treating sleep apnea with continuous positive airway pressure (CPAP) can lower high blood pressure in people with sleep apnea.15

C-reactive protein

C-reactive protein (CRP) is made by the body and released into the blood in response to swelling. Swelling (or inflammation) is how your body reacts to heal infections or cuts. Swelling can also happen over time in response to high stress levels or poor eating habits. Swelling for infections or cuts will raise your CRP levels for a short time, but swelling that continues for a long time may mean your arteries are damaged, which puts you at risk for heart disease.

If you are at borderline risk for heart disease, your doctor might test your blood for your CRP levels to use as a "tiebreaker." Your doctor may have to do this test several times to monitor your CRP levels. High CRP levels over several tests means that your risk of heart attack to about two to three times higher than people with low CRP levels.16 Women usually have higher CRP levels than men.17 Also, Hispanic and African-American women often have the highest CRP levels.18

Your CRP level can help your doctor decide whether you need to take steps to lower your CRP level to prevent heart disease. This may include changing your eating habits, getting more physical activity, or taking medicine to treat high blood pressure or high cholesterol.

Did we answer your question about heart disease risk factors?

For more information about heart disease risk factors, call the OWH Helpline at 1-800-994-9662 or check out the following resources from other organizations:

Sources

  1. Yoon, S.S., Fryar, C.D., Carroll, M.D. (2015). Hypertension prevalence and control among adults: United States, 2011–2014. NCHS data brief, no 220. Hyattsville, MD: National Center for Health Statistics.
  2. American Heart Association. (n.d.). Heart Disease in African-American Women.
  3. Dolezsar, C.M., McGrath, J.J., Herzig, A.J., Miller, S.B. (2014). Perceived racial discrimination and hypertension: a comprehensive systematic review. Health Psychology; 33(1): 20-34.
  4. Fryar, CD,Carroll, MD, and Ogden, CL. (2016). Prevalence of Overweight, Obesity, and Extreme Obesity Among Adults Aged 20 and Over: United States, 1960–1962 Through 2013–2014. Health E-Stats. Hyattsville, MD: National Center for Health Statistics.
  5. Arnetz, L., Ekberg, N.R., Alvarsson, M. (2014). Sex differences in type 2 diabetes: focus on disease course and outcomes. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy; 7: 409-420.
  6. Centers for Disease Control and Prevention. (2014). National Diabetes Statistics Report, 2014.
  7. Aguilar, M., Bhuket, t., Torres, S., Lui, B., Wong, R.J. (2015). Prevalence of the Metabolic Syndrome in the United States, 2003-2012. JAMA; 313(19): 1973-1974.
  8. Naess, I.A., Christiansen, S.C.,Romundstad, P.,Cannegieter, S.C., Rosendaal, F.R., Hammerstrom, J. (2007). Incidence and mortality of venous thrombosis: a population-based study. J Thromb Haemost; 5:692–9.
  9. Roach, R.E.J., Cannegieter, S.C., Lijfering, W.M. (2014). Differential risks in men and women for first and recurrent venous thrombosis: the role of genes and environment. J Thromb Haemost;12:1593–1600.
  10. Jacobson, D.L., Gange, S.J., Rose, N.R., Graham, N.M. (1997). Epidemiology and estimated population burden of selected autoimmune diseases in the United States. Clinical Immunology and immunopathology; 84(3): 223-43.
  11. Gleicher, N., Barad, D.H. (2007). Gender as risk factor for autoimmune diseases. Journal of Autoimmunity; 28(1): 1-6.
  12. Kessler, R.C., McGonagle, K.A., Swartz, M., Blazer, D.G., Nelson, C.B. (1993). Sex and depression in the National Comorbidity Survey. I: Lifetime prevalence, chronicity and recurrence. Journal of Affective Disorders; 29(2-3): 85-96.
  13. Shah, A.J., Ghasemzadeh, N., Zaragoza-Macias, E., Patel, R., Eapen, D.J., Neeland, I.J., et al. (2014). Sex and Age Differences in the Association of Depression With Obstructive Coronary Artery Disease and Adverse Cardiovascular Events. Journal of the American Heart Association; 3(3): e000741.
  14. Malhotra, A., Neilan, T.G., & Sarmiento, K. (2014). Obstructive sleep apnea and atrial fibrillation: Is the link real? Journal of the American College of Cardiology, 64(19), 2024–2025.
  15. Gottlieb, D.J., Punjabi, N.M., Mehra, R., Patel, S.R., Quan, S.F., Babineau, D.C. (2014). CPAP versus Oxygen in Obstructive Sleep Apnea. New England Journal of Medicine; 370:2276-2285.
  16. Ridker, P. M. (2003). C-reactive protein: a simple test to help predict risk of heart attack and stroke. Circulation, 108, e81–e85.
  17. Khera, A., McGuire, D.K., Murphy, S.A., Stanek, H.G., Das, S.R., Vongpatanasin, W., et al. (2005). Race and gender differences in C-reactive protein levels. Journal of the American College of Cardiology; 46(3): 464-9.
  18. Reiner, A.P., Beleza, S., Franceschini, N., Auer, P.L., Robinson, S.G., Kooperberg, C., et al. (2012). Genome-wide association and population genetic analysis of C-reactive protein in African American and Hispanic American women. American Journal of Human Genetics; 91(3): 502-12.