Dr. Beth Abramson
Preventive cardiologist, Chair in Cardiovascular Prevention and Women’s Health at the University of Toronto
Heart disease remains the leading cause of death among women, yet many still believe it’s primarily a man’s disease. Dr. Beth Abramson explains why women need to start putting their heart health first—and what every Canadian should know about prevention.
Heart disease is still widely viewed as a men’s disease. Why does that misconception persist, and what do you wish every woman knew?
Heart disease is the leading cause of death and disability among women—not just in Canada, but around the world. While we’ve made progress, many women still don’t recognize that they are at significant risk.
The face of heart disease has changed. It’s no longer a disease affecting only older men. Women develop cardiovascular disease too, and while some of their risk factors and conditions are unique, many of the common causes of heart attack and stroke affect both men and women.
The most important message is simple: women need to understand that heart disease is their leading health threat, and they need to make their heart health a priority.
How does cardiovascular disease differ between women and men?
Women often develop traditional cardiovascular disease later than men, largely because estrogen provides some protection before menopause. After menopause, however, that protection begins to disappear, and women quickly catch up.
The traditional risk factors remain the same—high blood pressure, high cholesterol, diabetes, smoking, excess weight and family history—but they often become much more apparent after midlife.
Women can also develop certain cardiovascular conditions more commonly than men, but the biggest issue is ensuring women recognize that the “common” forms of heart disease and stroke absolutely affect them too.
Which heart disease risk factors are most commonly overlooked?
One of the biggest misconceptions is believing you’re healthy simply because you feel well. Many cardiovascular risk factors don’t cause symptoms until significant damage has already occurred.
A heart health assessment doesn’t require expensive scans or advanced imaging. It starts with the basics:
- Knowing your blood pressure
- Checking your cholesterol
- Understanding your diabetes risk
- Discussing family history
- Maintaining a healthy weight
- Staying physically active
One test that’s increasingly important is Lipoprotein(a), or Lp(a)—a genetically inherited form of cholesterol that should be checked at least once during adulthood. Many people have elevated levels without realizing it. too.
Are there women’s health issues that should be considered cardiovascular risk factors?
Absolutely.
Pregnancy history is incredibly important but is still too often overlooked. Women who experienced high blood pressure, diabetes, preeclampsia or other placental complications during pregnancy have a substantially higher lifetime risk of cardiovascular disease—even decades later.
Menopause is another critical turning point.
Women who experience menopause earlier than average are at increased cardiovascular risk because they’re losing hormonal protection sooner. I encourage women to view midlife as an opportunity—not just to manage menopausal symptoms—but to have an honest conversation about their future heart health.
Why do so many women struggle to prioritize their own heart health?
During midlife, many are balancing careers, aging parents, children and countless other responsibilities. I’ve often referred to this as the “Type E Personality”—women trying to be everything for everyone except themselves.
That’s why it’s so important to intentionally prioritize your own health. Even one appointment with your healthcare provider to review your cardiovascular risk can make a significant difference.
What role does prevention play in reducing cardiovascular disease?
Prevention is one of the most powerful tools we have.
Healthy eating, regular physical activity, maintaining a healthy weight and not smoking remain the foundation of cardiovascular prevention. But prevention also means identifying risk early and using evidence-based treatments when appropriate.
Today we have better medications than ever before for cholesterol, diabetes and cardiovascular disease. Patients who have already experienced a heart attack or stroke are living longer, healthier lives because we’re treating risk more aggressively than we did even a decade ago.
What final message would you like readers to remember this World Heart Day?
It’s never too early, too late or too healthy to start looking after your heart.
Know your numbers. Understand your personal risk. Have conversations with your healthcare provider. And remember that heart disease is not inevitable—many heart attacks and strokes can be prevented with early awareness, healthy lifestyle choices and appropriate treatment.
The best time to start taking care of your heart is today.