Heart disease remains the leading cause of death for U.S. women, and NYU Langone cardiologists say stalled awareness and missed sex-specific risks demand earlier screening, better prevention, and tailored care across pregnancy, menopause, and aging.
Heart disease continues to outpace all other causes of death among women in the United States, even as many younger women and women of color underestimate their cardiovascular risk. Physicians at NYU Langone Health say rising rates of high blood pressure, diabetes, obesity, and high cholesterol make early intervention more urgent than ever.
Experts from the Leon H. Charney Division of Cardiology say advances in research and technology are reshaping women’s heart care, but gaps in education and screening persist. They emphasize that pregnancy history, menopause, and subtle symptoms often overlooked in women must become central to routine care.
Pregnancy Signals Lifelong Heart Risk
Pregnancy complications are among the strongest early indicators of future cardiovascular disease, according to NYU Langone cardiologists, who stress the importance of recognizing these risks for timely prevention and care.
“Pregnancy is what we call nature’s stress test,” said Dr. Anaïs Hausvater, co-director of NYU Langone’s Cardio-Obstetrics Program. Blood volume and heart rate rise sharply, placing extra strain on the heart.
Conditions such as preeclampsia, gestational diabetes, pregnancy-related hypertension, preterm birth, and pregnancy loss are now recognized as long-term risk markers. These risks do not end after delivery.
“Even thirty to forty years later, we see higher rates of heart disease, heart failure, and stroke,” Hausvater said.
Doctors say documenting pregnancy history should be standard practice, as it can guide earlier screening and prevention decades before symptoms appear.
Menopause and Symptoms Often Go Unnoticed
Women face cardiovascular risks tied to biology and life stages that traditional screenings may miss. Early menopause, autoimmune disease, polycystic ovary syndrome and certain cancer treatments are increasingly linked to heart disease.
“We need to bring these factors into everyday clinical conversations,” said Dr. Harmony R. Reynolds, director of the Cardiovascular Clinical Research Center at NYU Langone. “That’s how women receive more personalized risk assessments.”
Menopause represents a major transition, when cholesterol and blood pressure often rise. Physicians call it a critical window for reassessing risk and starting preventive therapy.
Heart attack symptoms can also differ in women, particularly younger patients. Instead of classic blocked-artery heart attacks, women may experience artery spasms, small-vessel disease, or spontaneous coronary artery dissection.
“These patients don’t fit the traditional heart disease profile,” said Dr. Doris Chan, an interventional cardiologist at NYU Langone Hospital, Brooklyn. Misinterpretation of symptoms as anxiety or digestive issues can delay diagnosis and treatment.
New Technology Expands Detection and Treatment
Advances in diagnostics and consumer technology are improving the detection of conditions once frequently missed in women. Smartwatches and wearable devices can identify abnormal heart rhythms, sleep apnea, and dangerous pauses in heart rate.
“These tools can absolutely save lives,” said Dr. Nathaniel R. Smilowitz, an interventional cardiologist at NYU Langone. NYU Langone cardiologists emphasize that wearable data should be reviewed with clinicians to avoid unnecessary anxiety and ensure accurate guidance.
Heart failure also presents differently in women. They are more likely to develop heart failure with preserved ejection fraction, in which the heart pumps normally but cannot relax properly.
“Symptoms like fatigue and shortness of breath can be just as serious,” said Dr. Shaline D. Rao, chief of cardiology at NYU Langone Hospital—Long Island. She said newer therapies and cardiac rehabilitation are improving the quality of life.
Despite strong evidence, statins remain underused in women. “They are one of the most powerful tools we have to reduce heart attack and stroke risk,” Chan said, noting misinformation often deters treatment.
NYU Langone cardiologists urge women to know their blood pressure, cholesterol, and blood sugar levels, share reproductive history, take persistent symptoms seriously, and ask about personalized risk at every life stage.
“Women’s heart disease is not one-size-fits-all,” Reynolds said. “Acting on these differences early can save lives.”
