Heart disease is responsible for about one in every five deaths in women, according to U.S. health officials.
According to Johns Hopkins Medicine, men develop cardiovascular disease a decade earlier than women on average—meaning many efforts to improve heart health tend to focus on their particular risk factors. However, the U.S. Centers Disease Control and Prevention (CDC) reports that heart disease is also the leading cause of death in women, and new research shows that several important sex-specific considerations still remain overlooked.
One particular study published in the Singapore Medical Journal in September 2025 says that four health variables pertaining to women play a major role in shaping long-term heart health:
- Hypertensive and metabolic disorders of pregnancy
- Preterm delivery
- Polycystic ovary syndrome (PCOS)
- Premature menopause
Pregnancy-related concerns such as preeclampsia or gestational diabetes are often treated as short-term health issues, but they signal a higher risk of future hypertension and heart disease, the study explains. Meanwhile, preterm delivery also raises a woman’s later cardiovascular risk, even though it is usually discussed only in relation to infant outcomes. Polycystic ovary syndrome, commonly referred to as PCOS, increases the chances of insulin resistance and metabolic syndrome, while premature menopause removes the protective effect of estrogen earlier in life, speeding up vascular ageing.
These factors are often missed in routine assessments—a mistake with potentially serious consequences. Many women with heart disease present with symptoms considered “less typical,” such as fatigue or dizziness, which can either result in a missed or delayed diagnosis. Biological differences can make heart conditions harder to recognize and treat, the study authors note.
The study reports that lifestyle patterns add extra risk, too. Even though fewer women smoke, tobacco use is 25% more likely to cause coronary artery disease in women than in men. Fewer women are quitting smoking these days, the study says, while obesity, high blood pressure and inactivity remain common. “Furthermore, psychological stress and caregiving roles contribute to a higher incidence of stress-induced cardiomyopathies” in women, the study states.
While it’s clear that the gender divide contributes to heart risk in a wide myriad of ways, recognizing these four risk factors can help improve early prevention and long-term care. Better screening around pregnancy, more attention to hormonal health, and greater inclusion of women in research can all support earlier intervention.
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