Predicting Heart Disease in Women

In 2007, the American Heart Association (AHA) initiated new guidelines to predict which women would develop heart disease.  As part of the AHA's new focus on women and heart health, these new guidelines help doctors evaluate women's risk factors for cardiac disease.  Three years after they were initiated, studies show they appear to be working well as a means of prediction and a framework to help doctors and women improve cardiac outcomes. 

Most studies of heart disease and heart health have historically been performed on men.  Cardiologists now recognize that heart disease may present itself differently in women, and serious cardiac risk factors and events may be ignored and misdiagnosed. Heart disease is the number one killer of women, however, and the AHA is campaigning to increase awareness of risk factors, signs, symptoms, and ways to reduce heart disease in women.

Before 2007, the Framingham Heart Study (launched in 1948), used seven characteristics to predict risk for heart problems over the following 10 years:

  • Age
  • Gender
  • Total cholesterol
  • HDL "good" cholesterol
  • Systolic blood pressure (upper number)
  • Need for blood pressure medication
  • Cigarette smoking

The new AHA guidelines provide a simpler and more straightforward method for

predicting women's odds of heart attack, stroke or other cardiovascular events over the next ten years.  This new research, published in the AHA journal, Circulation:  Cardiovascular Quality and Outcomes, breaks risk factors down into three categories:  high risk, at risk, or optimal (low) risk

  • High-risk women already had known cardiovascular disease, diabetes, chronic, or end-stage kidney disease.
  • At risk women had multiple risk factors for heart disease.  For example, they were smokers, had a poor diet, an inactive lifestyle, were obese, had a family history of early heart disease, high blood pressure, high cholesterol, had evidence of subclinical vascular disease, metabolic syndrome, or performed poorly on treadmill tests.
  • Optimal (low risk) women had healthy lifestyles that included regular exercise, good eating habits, and no risk factors. 

Some research indicates these new guidelines are more accurate than previous guidelines and seem to be easier for clinicians and patients to understand. That may make patients more motivated to improve lifestyle habits to decrease their risks. 

While some risk factors for heart disease (like family history and age) can't be changed, others, including smoking, exercise, and eating habits can.  Adopting healthier habits can have a dramatic impact on cardiac health no matter what age patients are when they start.

The American Heart Association recommends six steps for heart health:

  1. Avoid tobacco smoke
  2. Monitor high blood pressure
  3. Eat foods low in cholesterol and saturated fats
  4. Be physically active
  5. Maintain a healthy weight
  6. Have regular medical exams

When combined with stress reduction, proper sleep habits, and other elements of a healthy lifestyle, women can improve their heart health and significantly decrease their odds of developing heart disease.


American Heart Association