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Coronary heart disease and women

Coronary heart disease is the leading cause of death in Australian women and kills almost as many women as it does men. Women need to be aware of heart disease and how there may be some gender differences to be aware of.

What is coronary heart disease? 

Your heart is a sophisticated arrangement of muscles. Like any muscle tissue, it needs oxygen and nutrients to function. Coronary heart disease occurs when the blood vessels that supply oxygen and other nutrients to the heart muscles become clogged with a build up of fat, cholesterol and other materials (called plaques). This process is called atherosclerosis and occurs over time. It may eventually cause stiffening and narrowing of the coronary blood vessels, which reduces blood flow and oxygen to the heart.

Cholesterol and your heart health from Bupa Australia on Vimeo.

Reduced blood flow and oxygen to the heart muscles can lead to angina and heart attacks. Angina is chest pain or discomfort that occurs when a person's heart doesn't get enough blood. This pain can sometimes be experienced in the shoulders, arms, neck, jaw, or back, or may feel like indigestion.

Sometimes a plaque may rupture and a blood clot forms around it. The plaque and blood clot together can completely block the coronary artery, stopping blood flow and oxygen reaching the heart. This can lead to a heart attack.

What are the symptoms of coronary heart disease? 

The symptoms of heart disease can differ from person to person. Chest pain is the most common symptom. However more often than men, women describe other symptoms and warning signs of heart attack, with or without chest pain. These include:

  • back pain
  • jaw pain
  • neck pain
  • nausea
  • shortness of breath
  • dizziness
  • unexplained tiredness or fatigue.

If you have experienced any of these symptoms or have any questions or concerns about your health, it is recommended that you consult your doctor or other qualified health professional.

What can affect my risk of coronary heart disease? 

Older people are at increased risk of heart disease. Women generally experience heart disease later in life than men.

A woman’s chances of developing heart disease also increase after menopause, when the ovaries stop releasing eggs as a result of falling levels of oestrogen. The causes for this are debatable, but it appears that oestrogen may help have a role in protecting women from heart disease. However, hormone replacement therapy, which contains oestrogen and is used to treat the symptoms of menopause, is not recommended for the treatment or prevention of heart disease.

It’s important to remember that plaques can start to build up in your arteries before your teen years, although most people won’t experience symptoms of heart disease until much later. While risk factors like your age or gender can’t be changed other risk factors can be modified, and you can start to protect your heart at an earlier stage in life by paying attention to your these modifiable risk factors.

Behavioural risk factors

Risk factors that you can change are also known as behavioural risk factors and are generally linked to your lifestyle. These risk factors are responsible for about 80 percent of cardiovascular (heart and blood vessel) problems such as heart disease, and include:

  • Smoking (including second-hand smoke) – this can increase the speed at which cholesterol gets into the walls of the arteries. Smoking also increases the likelihood of blood clots forming, which can lead to heart attacks or stroke (a blood clot in a blood vessel in the brain)
  • being overweight, especially if you have excess fat around your abdominal area
  • an inactive lifestyle
  • high blood pressure
  • high cholesterol
  • drinking excessive amounts of alcohol
  • issues with social and emotional wellbeing – research supports a link between depression, socially isolation and lack of quality social support with the risk of developing coronary heart disease
  • eating an unhealthy diet – this includes eating foods that are high in saturated fat, cholesterol, salt and sugar.

Understanding absolute risk

At least 91 percent of women in Australia have one or more of these risk factors. The more risk factors you have and/or the more severe they are, the more likely you are to experience a heart attack or other cardiovascular problems. This is because the effect of each risk factor is cumulative. A single risk factor may be of little concern, but when added to other risk factors it can put you at serious risk of developing heart disease.

The cumulative effect of risk factors is called ‘absolute risk’. The good news is that the more risk factors you manage successfully, the greater your chances of preventing heart disease and other cardiovascular problems. Your doctor can assess your absolute risk and help you make simple changes to your lifestyle habits. Even if you already have heart disease, leading a healthy lifestyle can help reduce the risk of further health issues.

How can I reduce my risks of coronary heart disease? 

You may experience no symptoms with cardiovascular disease. The first warning that you have is a stroke or heart attack. This is why it is important to try and help reduce your risks by living a healthier lifestyle.

  • Quit smoking – the risk of heart attack and stroke starts to fall immediately you stop using tobacco products. It is especially important to quit smoking if you are taking the oral contraceptive pill. Smoking while taking ‘the pill’ greatly increases your risk of CHD and stroke.
  • Reduce your saturated and trans fat intake – these fats increase blood cholesterol and heart attack rates.
  • Know your health risk factors – check your cholesterol, blood pressure, blood sugar and waist circumference regularly.
  • Be physically active – aim for 2 ½ –5 hours a week of moderate-intensity activity, such has brisk walking or swimming. For more vigorous activities such as competitive sports, aerobics or jogging you can do less – between 1¼ and 2 ½ hours a week is recommended. If you are over 65 years, aim for at least 3½ hours of moderate-intensity activity weekly. Generally, the more active you can be the better.
  • Sit less – It is also good to minimise the time you spend in prolonged sitting. Sedentary behaviour may increase your risk of developing type 2 diabetes.
  • Maintain a healthy weight.
  • Look after your social and emotional wellbeing.

Further information 

National Heart Foundation of Australia


Australian Institute of Health and Welfare (AIHW). Australia’s health 2012, no.13. Cat. no. AUS 156. Canberra: AIHW.

AIHW. Women and heart disease, 2010, no.33. Cat. no. CVD 49. Canberra: AIHW. Colquhoun DM, Bunker S, Clarke DM et al. Screening, referral and treatment of depression in patients with coronary heart disease. A consensus statement from the National Heart Foundation of Australia. MJA 2013; 198: 1–7.

Department of Health. Australia’s physical activity and sedentary behaviour guidelines. 2014 [online] [Accessed 8 May 2014]. Available from:

Kris-Etherton PM Hu FB Ros E Sabate J. The role of tree nuts and peanuts in the prevention of coronary heart disease: multiple potential mechanisms (review article). J Nutr 2008; 138: 1746S–1751S.

Merck manual for health care professionals. Overview of coronary artery disease [Online]. c2004–2013 [Last updated May 2013; accessed 7 May 2014]. Available from:

National Vascular Disease Prevention Alliance (NVDPA). Quick reference guide for health professionals. Absolute cardiovascular disease risk assessment. Available from:

NVDPA. Manage your heart and stroke risk. A 3-step guide to better health. Available from:

National Heart Foundation of Australia. Cardiovascular conditions: coronary heart disease. [Online] [Accessed 7 May 2014]. Available from:

National Heart Foundation of Australia. Cardiovascular conditions: angina. [Online] [Accessed 7 May 2014]. Available from:

National Heart Foundation of Australia. Cigarette smoking factsheet, 2002. Available from:

National Heart Foundation of Australia. Know the risks. [Online] [Accessed 7 May 2014]. Available from:

National Heart Foundation of Australia. Women and heart disease. [Online] [Accessed 8 May 2014]. Available from:

State Government of Victoria. Better Health Channel. Heart disease and food [Online]. [Last updated February 2014; accessed 8 May 2014]. Available from:

World Health Organization. Cardiovascular disease (CVDs) factsheet [online]. [Updated March 2013; accessed 8 May 2014]. Available from:

Last updated: 13 May 2014

This information has been developed and reviewed for Bupa by health professionals. To the best of their knowledge it is current and based on reputable sources of medical research. It should be used as a guide only and should not be relied upon as a substitute for professional medical or other health professional advice.

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