Knowing a Woman’s Risk for Heart Disease at Every Age and Stage of Life

Cardiovascular disease remains women’s greatest health threat. It is the number one killer of women, causing one in three deaths each year. And among females 20 years and older, nearly 45% are living with some cardiovascular problem.

That is why Katherine Shreyder, MD, is on a mission to better educate women about their risk factors for heart disease. Traditional risk factors such as high cholesterol, high blood pressure, diabetes, obesity, physical inactivity, and family history are prevalent in both sexes. However, Dr. Shreyder notes that the life events and conditions unique to women listed below may increase their chances of a cardiovascular event.

Menstrual Cycles
“Hormonal fluctuations certainly affect the cardiovascular system in women. We know, for example, that menstruating females are at higher risk of experiencing palpitations, or irregular or pounding heartbeats, in the second phase of the menstrual cycle,” says Dr. Shreyder. “The vast majority of these arrythmias are benign and need not be treated, but some may require additional workup and possibly medication or intervention.”

Additionally, women with irregular menstrual cycles may be at higher risk for heart problems.

Less than half of American women entering pregnancy have optimal cardiovascular health, and pregnancy adds extra strain on a woman’s heart and blood vessels that may have lasting effects on her long-term health.

Complications during pregnancy are becoming more common, and unfortunately, they are often overlooked as a warning sign about women’s heart health. Issues such as miscarriages, preeclampsia, gestational diabetes, and low birth weight of a baby can greatly increase a women’s risk for developing cardiovascular disease later in life.

Dr. Shreyder stresses, “Approximately 70% of women with gestational diabetes will develop type two diabetes later in life. And if you have diabetes, you’re twice as likely to have heart disease or a stroke.”

The age at which a woman reaches menopause may be considered an important factor in assessing the risk of heart disease. While going through menopause does not cause cardiovascular disease, menopause marks a point in a woman’s life when risk factors can accelerate.

“Besides the change in sex hormones, menopause causes unfavorable change in body fat distribution, lipids, and lipoproteins. There is also increased sensitivity to sodium, leading to fluid retention and elevated blood pressure,” explains Dr. Shreyder.

Polycystic Ovarian Syndrome (PCOS)
Studies suggest that women with PCOS are twice as likely to develop heart problems. Elevated cholesterol, high blood pressure, increased insulin levels, and glucose intolerance are common in women with PCOS—all of which escalate the risk of developing both diabetes and heart disease.

Breast Cancer
“Breast cancer itself can be a risk factor of coronary artery disease, but cancer treatments such as chemotherapy and radiation are more likely to increase the probability of cardiovascular condition,” notes Dr. Shreyder. Radiation therapy for breast cancer, for example, can facilitate the progression of plaque buildup in heart arteries and the heart valve, while chemotherapy may weaken the heart muscle and cause cardiomyopathy.

It’s evident that cardiovascular disease can affect a woman at any age, making it vital for all women to understand their personal risk factors. Some risk factors you can’t do anything about, but others can be managed or even treated with the help of a healthcare provider such as Dr. Shreyder.

“A visit to a cardiologist shouldn’t happen only when a problem exists. A large part of what cardiologists do is a preventive cardiology,” shares Dr. Shreyder. “If you think you have really strong risk factors and/or a family history of cardiovascular disease, it is reasonable to see a cardiologist for preventive purposes.”

Dr. Shreyder continues, “We can analyze cholesterol and its fractions, specific proteins and lipoproteins linked with heart disease risk, and A1C levels through blood work. We can utilize the coronary calcium CT for early detection of plaque buildup. We can complete an ultrasound of the carotid arteries that go to the brain to look for initial blockages. The results of these sorts of tests enable us to target preventive measures based on a patient’s background, risks, and needs. ”

In addition to regularly seeing a physician to monitor wellness, there are many ways women can support their heart health between appointments. The most important one is physical activity—getting at least 150 minutes per week of aerobic exercise can significantly improve cardiac risk. Plus, home blood pressure and weight checks can provide individuals and their physicians with important data. Additionally, calorie and sodium intake tracking apps available on smartphones are helpful in maintaining a heart healthy diet.

While most problems can be prevented with education and lifestyle changes, cardiovascular disease will impact some women at higher rates than others. “For some patients, an excellent lifestyle unfortunately might be not enough, and we may have to add medications to their routine. These days, we are lucky to have a variety of medications that help to prevent cardiovascular problems and are designed for long-term use with minimal side effects.”

If you are searching for a cardiologist, Dr. Shreyder is currently accepting new patients at multiple St. Clair Medical Group Cardiology locations. Visit to learn more about Dr. Shreyder and call 412.942.7900 to request an appointment.