1. What is cardiovascular disease CVD?
   1.1 Types and forms of CVD
   1.2 Common symptoms of CVD
   1.3 Symptoms of CVD for women
2. How heart health risk is shaped for women
   2.1 Common risk factors for cardiovascular disease
   2.2 Risk factors for women
3. What women can do to support their heart health
4. Gender gaps in heart health
   4.1 The need for women-specific action
   

What is cardiovascular disease (CVD)? 

Many people think that cardiovascular disease is a health issue that mainly affects men, but it’s not. CVD has a significant impact on women’s health outcomes. More than half a million women in Australia are diagnosed with CVD each year (Heart Health Jean Hailes).  In 2023, coronary heart disease was the second leading cause of death for females in Australia, accounting for 7.6% of all deaths in females (Australian Institute of Health and Welfare). Almost every hour of every day, an Australian woman dies of coronary heart disease. On average, that equates to 20 women each day (Heart Foundation).  

Types and forms of CVD 

Cardiovascular disease is not a single condition but a group of related conditions affecting the heart and blood vessels, including: 

• Coronary heart disease: caused by narrowed or blocked arteries supplying the heart 
• Heart attack: when blood flow to part of the heart muscle is suddenly reduced or blocked 
• Angina: which causes chest pain due to reduced blood flow to the heart 
• Heart failure: where the heart cannot pump blood effectively 
• Stroke: caused by blocked or ruptured blood vessels supplying the brain 
• Spontaneous coronary artery dissection (SCAD): a tear forms in the heart wall artery, a condition that disproportionately affects women and can occur in people without traditional cardiovascular risk factors 
  
  Source: Australian Heart Research  

Common symptoms of CVD 

Cardiovascular disease is commonly associated with symptoms such as: 

• Chest pain or discomfort 
• Shortness of breath 
• Pain or discomfort in the arms, the left shoulder, neck, or back.   
  
  Source: WHO CVD

These symptoms are often presented as the “classic” signs of heart disease. However, they do not capture the full range of symptoms experienced by many people, particularly women. It is important to know that heart attack symptoms can be different in women. Women are more likely to experience symptoms that are subtle, atypical, or do not involve chest pain. 

Symptoms commonly reported by women include: 

Know the Symptoms – Health Information Video

How heart health risk is shaped for women 

Common risk factors for cardiovascular disease 

Some risk factors for cardiovascular disease affect people of all genders. These are often referred to as common or general risk factors and are widely recognised in heart health research and practice. Common cardiovascular disease risk factors include: 

• High blood pressure (hypertension) 
• High cholesterol, including abnormal blood lipid levels 
• Smoking, including exposure to second‑hand smoke 
• Diabetes 
• Overweight and obesity 
• Low levels of physical activity 
• Unhealthy diet, including diets high in salt, saturated fat and sugar 
• Excessive alcohol consumption 
• Older age 
• Family history of cardiovascular disease 
  
  Source: CDC Heart Disease  

Many people experience more than one risk factor at the same time, further increasing their risk of developing cardiovascular disease. Some of these risk factors are related to lifestyle and environment, while others, such as age and family history, cannot be changed. 

While these risk factors are important, they do not fully explain how cardiovascular disease affects women. Focusing only on these general factors can overlook additional risks linked to women’s hormones, reproductive health and life stages. 

Risk factors that are unique to women 

Women’s risk of cardiovascular disease is not fixed; it changes across the life course. Women experience additional cardiovascular risk factors that are shaped by hormonal, reproductive and life‑stage factors. There is growing recognition that the causes, risk factors, symptoms, diagnosis, treatment and outcomes of heart disease differ by gender and sex, yet these differences are not always reflected in routine care. 

• Autoimmune diseases: These are more common in women than men and are associated with increased cardiovascular risk. These conditions involve chronic inflammation, which can affect blood vessels and heart function over time. Because autoimmune diseases are often managed separately from heart health, their impact on cardiovascular risk may not always be fully recognised or monitored. 
• Polycystic ovary syndrome (PCOS): PCOS is a hormonal condition that affects many women and is linked to increased cardiovascular risk. It can influence metabolism, hormone levels and long‑term health, making it an important factor to consider when assessing women’s heart health, particularly earlier in life. 
• Pregnancy‑related complications: They can have lasting effects on cardiovascular health. Certain complications (such as gestational diabetes, pre-eclampsia / eclampsia, pre-term birth or delivering a baby smaller than average) are associated with an increased risk of heart disease later in life, even years after pregnancy. However, pregnancy history is not always routinely considered in cardiovascular risk assessments, which can contribute to missed opportunities for prevention and early intervention. 
• Menopause and hormonal changes: Hormonal changes play a key role in women’s heart health. Before menopause, estrogen provides a protective effect by supporting healthy blood vessels, helping regulate cholesterol levels, and reducing inflammation and fat build‑up in the arteries. During perimenopause and menopause, estrogen levels fall and these protective effects decrease. From midlife onward, women’s risk of coronary artery disease, heart attack and stroke increases. After menopause, women’s overall cardiovascular risk approaches that of men. Women who experience premature or early menopause may face increased risk earlier in life. 
  
  Source: World Heart Foundation  

Understanding both common and women‑specific cardiovascular risk factors is essential to improving heart health outcomes. Recognising how women’s risk changes across life stages highlights the need for better awareness, gender‑responsive risk assessment, and health systems that support women to seek and receive timely, appropriate care.  

Risk factors for Women – Health Information Video:

What women can do to support their heart health 

Not all cardiovascular risk factors can be controlled. Factors such as age, genetics, family history, and some health conditions are outside an individual’s control. However, women can take steps to better understand their heart health, recognise risk earlier, and advocate for care that reflects their experiences. 

Know your risk and make it visible:  
Understanding personal cardiovascular risk can help women start earlier and more informed conversations with healthcare providers, particularly in systems where women’s risk is often underestimated. 

Women aged 45 years and over (or 30 years and over for Aboriginal and/or Torres Strait Islander women) are eligible for a Heart Health Check with their GP. This is a free 20‑minute check‑up (bulk‑billed at participating practices) that assesses factors such as blood pressure, blood sugar and cholesterol, and estimates the risk of a heart attack or stroke in the next five years. 

For women, sharing relevant health history (such as pregnancy complications, early menopause or autoimmune disease) is an important part of making risk visible in clinical settings. Even when feeling well, having a Heart Health Check can support early prevention and monitoring. 

Use tools to support conversations and self‑advocacy:
Several evidence based tools are available to help women better understand their cardiovascular risk and support informed conversations with healthcare providers. The 3-minute Heart Age Calculator by Heart Foundation provides a quick snapshot of heart health by comparing risk factors to others of the same age. The Australian CVD Risk Calculator, which is used in clinical care, helps estimate a person’s risk of having a cardiovascular event and supports decision making about prevention and follow up. Community members and health professionals can also request additional resources such as the Her Heart Checklist and Her Heart Wallet Card. In addition, the Find a Female Cardiologist resource on the Her Heart website can support women to access specialist care by helping them locate female cardiologists across Australia.

These tools are intended to guide discussion and support self‑advocacy, not replace medical advice. They may not fully capture women‑specific or life‑stage‑related risks, which is why access to women‑centred, gender‑responsive healthcare remains essential. 

Support your heart health day‑to‑day:
Regular physical activity, nutritious diet, and reducing added salt can help support heart health. Movement does not need to be intense or done all at once, even short periods of activity spread across the day (such as 10 minutes, three times a day) can be beneficial.

Mental wellbeing is also important. Ongoing stress and poor sleep are linked to increased cardiovascular risk in women. Regularly sleeping less than seven hours or more than nine hours a night has been associated with increased risk of obesity, high blood pressure, diabetes and cardiovascular disease. Prioritising rest, support and recovery, in the context of work, caring responsibilities and daily pressures, is an important part of heart health.   

Trust your instincts and act early:
Women are encouraged to trust their instincts if something does not feel right. Acting early when symptoms are concerning supports faster treatment and improves outcomes. Women may need to advocate for themselves within healthcare systems that have not always been designed with women in mind. Asking questions, sharing relevant health history, and seeking a second opinion when concerns persist can all support better care. 

Supporting women to reduce cardiovascular risk requires more than individual awareness. Tools and lifestyle strategies are most effective when women have access to healthcare that listens, takes symptoms seriously, and responds to women’s specific risks and life experiences. 

Improving women’s heart health means empowering women and strengthening health systems to deliver timely, equitable care informed by women’s lives.

Gender gaps in heart health 

There is a long‑standing legacy of cardiovascular disease being positioned primarily as a men’s health issue, alongside a widespread misperception that women are protected from heart disease. This framing has contributed to cardiovascular disease in women being under‑recognised, under‑diagnosed and under‑researched. As a result, women’s experiences of heart disease have often been overlooked in research, clinical guidelines and health messaging. 

Gender bias within healthcare settings has contributed to differences in how women experience care before, during and after cardiac events. Evidence shows that women are less likely than men to undergo treatment for heart attack or angina (chest pain) in hospital, which can contribute to poorer outcomes and recovery. 

Differences have also been documented across diagnosis, access to services, medications, and treatment pathways. These inequities highlight the limitations of healthcare models and clinical guidelines that have historically been developed using male populations and male patterns of disease. 

Women are also more likely to hesitate before calling emergency medical services when experiencing heart attack symptoms. Research by Monash University, based on two national surveys involving more than 34,000 participants, found that women were more likely than men to delay calling emergency services during heart attack symptoms. Women living in outer regional or remote areas of Victoria were even less likely to seek emergency assistance. 

A lack of knowledge about heart attack symptoms was identified as a key factor contributing to women’s hesitation to seek help. These delays are critical, as early treatment plays an essential role in reducing heart damage and improving outcomes following a cardiac event. 

Access to gender‑sensitive cardiac care is also shaped by workforce limitations. With only around 15% of cardiologists in Australia being women, many regions (particularly regional and rural areas) do not have access to a female cardiologist. This highlights the need for health systems and referral pathways to prioritise gender‑responsive care regardless of provider gender, and to support access to cardiologists with expertise in women’s heart health. 

Together, gender bias in healthcare, differences in symptom recognition, and delays in seeking emergency care contribute to inequities in heart health outcomes for women. These issues are not the result of individual choice alone, but reflect systemic gaps in knowledge, research, service design and public health messaging. 

The need for women‑specific action 

Addressing gendered disparities in heart health requires action across research, policy and practice. Improving cardiovascular outcomes for women depends on: 

• Increased women‑specific cardiovascular research 
• Clinical guidelines that reflect women’s symptom patterns and risk factors 
• Greater awareness of gender bias in heart health care 
• Equitable access to evidence‑based information, practical resources and support services 

Cardiovascular disease affects women across Australia, yet women’s experiences of heart disease continue to be overlooked. Addressing heart health through a gendered lens is essential to reducing inequities and ensuring women receive timely, appropriate care. 

By improving awareness, strengthening research, and embedding gender‑responsive approaches across health systems, we can better support women to protect their heart health, seek help earlier, and reduce their risk of chronic disease.