Why Women’s Hearts Age Differently—and How To Protect Yours

Many women don’t realize that heart disease impacts men and women at similar rates. There are a few reasons for this, and a big one is that men develop heart disease roughly a decade earlier than women and have higher rates of heart disease overall. But it’s a complete myth to believe that cardiovascular disease is a “man’s problem.” It’s important to know that heart disease is the leading cause of death in both men and women.

When it comes to being proactive about your heart health, much of the advice applies to both men and women. This includes knowing your blood pressure and cholesterol numbers, considering your genetic risks, eating a heart-healthy diet, exercising regularly, not smoking, getting enough sleep, healthily managing stress and taking blood pressure- or cholesterol-lowering medications, if needed. 

That said, there are ways that heart health is different for women than it is for men. As women, it’s important to know how life stages like pregnancy and menopause impact heart health long-term.

Didn’t know they did? You’re not alone—according to the results of the Cleveland Clinic’s 2026 survey, 71% are unaware that a woman’s risk of heart disease increases after menopause. Here, Dr. Leslie Cho, MD, a cardiologist and the director of Cleveland Clinic’s Women’s Cardiovascular Center, shares everything you need to know.   

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How Pregnancy Can Impact Heart Health

Dr. Cho says that many women don’t know that having preeclampsia or gestational diabetes during pregnancy has a lifelong impact on heart health. She explains that having either of these conditions is a very high risk factor for getting high blood pressure, developing diabetes, developing heart disease or dying of heart failure later in life.

A 2020 scientific article published in the Journal of the American College of Cardiology, which was authored by Dr. Cho, backs this up. The article states that having high blood pressure during pregnancy doubles the chances of getting cardiovascular disease later in life—that’s significant. 

Related: What’s More Important for Heart Health: Lowering Dietary Cholesterol or Saturated Fat?

“Pregnancy is like a stress test. It’s a peek into what’s going to happen as you get older. The placenta ages very quickly during the nine months of pregnancy and it’s like a crystal ball into your cardiovascular health as you get older,” Dr. Cho explains.

If you had preeclampsia or gestational diabetes during pregnancy, learning about this lifelong connection can be disheartening (no pun intended). But knowledge is power. Dr. Cho emphasizes that what’s most important is being aware of the connections so you can stay vigilant about your heart health, regularly monitoring your blood pressure and cholesterol levels. That way, you can take action if your numbers are in an unhealthy range, which could include taking prescription medication.

Related: The Heart-Healthy Habit Cardiologists Say Most People Quit Way Too Soon

How Menopause Impacts Heart Health

Menopause also impacts heart health in ways that men don’t experience. Dr. Cho explains that estrogen is protective for heart health, so before menopause, women’s risk of cardiovascular disease is actually lower than men’s. But during menopause, estrogen levels decrease, and women lose that extra protection. 

Because of this, she says that many women experience an increase in cholesterol and blood pressure after menopause. “It may actually be more related to age than to menopause,” Dr. Cho says. Either way, it’s important to know that it can happen because high cholesterol and high blood pressure are both major risk factors for cardiovascular disease. Many women also gain weight during and after menopause. This too can increase the risk of cardiovascular disease.  

Related: The Heart Health Issue Nearly 1 in 5 People Don’t Know They Have, According to Cardiologists

Ready for the good news? High blood pressure, high cholesterol and weight gain are all modifiable risk factors. That means they are controllable and can be reversed. Perhaps you are already familiar with the diet and lifestyle habits that support heart health: Eating a primarily plant-based diet, getting regular exercise, getting enough sleep and having healthy habits in place for managing stress. 

While these habits are all certainly important for heart health, Dr. Cho says that often they are not enough. For many people, prescription blood pressure-lowering or cholesterol-lowering medications are a crucial way of protecting their hearts. 

“Women are less likely to take prescription medication than men, even if they need it,” Dr. Cho says. There are several reasons for this. Dr. Cho says that the side effects of medications may hit women harder because women tend to have a smaller body mass than men and are also underrepresented in clinical trials for medications.

But Dr. Cho says that many women see taking prescription medication as a moral failure, something that it absolutely isn’t. “Aging alone increases the risk for high cholesterol and high blood pressure. That’s just aging. Even if you eat perfectly, you can still have high blood pressure or high cholesterol,” she explains.

As if lowering your risk of cardiovascular disease wasn’t enough of a reason to take any needed blood pressure medications, Dr. Cho says that these medications also lower the risk of dementia. This, she explains, is because they allow for better blood flow to the brain, and better blood flow to the brain lowers the risk of dementia. 

It’s important for everyone, regardless of sex, to be proactive about their heart health. For women, this means knowing how the life stages we go through specifically impact us. That way, you can be proactive about your health. It just might add years to your life.

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Sources:

• Cleveland Clinic Survey Finds Americans Optimistic about Aging Well, But Many Overlook Heart Disease Risks. Cleveland Clinic.
• Maas, A. and Appelman, Y. (2010). Gender differences in coronary heart disease. Netherlands Heart Journal. 18(12):598-602
• Dr. Leslie Cho, MD, cardiologist and the director of Cleveland Clinic’s Women’s Cardiovascular Center
• Cho, L., Davism M., Elgendy, I., et al. (2020). Summary of Updated Recommendations for Primary Prevention of Cardiovascular Disease in Women. Journal of the American College of Cardiology. 75;20
• Xiang, D., Liu, Y., Zhou, S., et al. (2021). Protective Effects of Estrogen on Cardiovascular Disease Mediated by Oxidative Stress.Oxidative Medicine and Cellular Longevity. 2021:5523516. doi: 10.1155/2021/5523516
• Zhang, Y., Vittinghoff, E., Pletcher, M.J., et al. (2019). Associations of Blood Pressure and Cholesterol Levels During Young Adulthood With Later Cardiovascular Events. Journal of the American College of Cardiology. 74(3):330-341
• Kodoth, V., Scaccia, S. and Aggarwal, B. (2022). Adverse Changes in Body Composition During the Menopausal Transition and Relation to Cardiovascular Risk: A Contemporary Review. Women’s Health Reports. 3(1):573-781
• Westphal Filho, F., Moss Lopes, P. R., de Almeida, A.M., et al. (2025). Statin use and dementia risk: A systematic review and updated meta-analysis.Alzheimer’s & Dementia. 11(1):e70039