C. Noel Bairey Merz, MD, director of the Barbra Streisand Women’s Heart Center at the Smidt Heart Institute at Cedars-Sinai, has raised concerns about how heart disease in women is often overlooked or misdiagnosed by healthcare providers.
“Too often, when a young woman has heart disease symptoms, a physician will ignore those symptoms and tell her that she needs to lose weight,” Bairey Merz said. “That’s because heart disease symptoms in women can be very different from what men experience. So it’s crucial that women know what to look for.”
Heart disease remains the leading cause of death among women in the United States, as reported by the Centers for Disease Control and Prevention. However, much of the research on heart disease has focused on men. Bairey Merz pointed out that even though rates of heart disease and heart attacks are increasing among women aged 35 to 54, they are less likely to receive evidence-based treatments such as statins and more likely to be told they are “too young” to have heart disease.
“These delays and dismissals have had serious consequences,” she said. “The Women’s Ischemia Syndrome Evaluation [WISE] study that I led for the National Heart, Lung, and Blood Institute helped us better understand that heart disease doesn’t always look the same in women. That insight ultimately pushed the field to rethink and improve how we diagnose and treat it.”
Despite advancements in understanding gender differences in cardiac health, Bairey Merz noted that women with heart disease continue to face higher rates of misdiagnosis or delayed treatment.
“The good news is that heart disease is largely preventable,” Bairey Merz said. “And for women in particular—who may not experience obvious symptoms or whose symptoms are subtle—knowledge is a powerful prevention tool.”
Bairey Merz addressed common misconceptions about heart disease: many believe it mainly affects men or think cancer is a greater threat. She emphasized: “In reality, heart disease kills more women than all cancers combined, yet fewer than half of women recognize it as their greatest health threat.” She added that while men tend to develop cardiovascular issues earlier in life, outcomes tend to be worse for women.
Regarding rising rates of cardiac events among younger adults, Bairey Merz cited factors such as low physical activity levels, increasing obesity and diabetes rates, chronic stress, prolonged sedentary behavior, and environmental exposures like air pollution.
Symptoms of a heart attack can differ between genders. While some people experience classic chest pain radiating down the arm—the so-called “Hollywood heart attack”—women may have subtler signs including shortness of breath, nausea, fatigue, back or jaw pain or mild chest discomfort.
“Because these symptoms don’t match common expectations of a heart attack,” she explained,“they may be overlooked or dismissed. Anyone experiencing them should seek medical care immediately.”
She also discussed conditions like ischemia with no obstructive coronary artery disease (INOCA), which involves reduced blood flow without significant blockages in major arteries—a pattern more frequently seen in women than men.
A normal resting adult heartbeat ranges from 60–100 beats per minute according to guidelines; due to generally smaller hearts,“women’s resting rate may run slightly higher than men’s.” She advised consulting a doctor if resting rates fall outside this range when not exercising.
Bairey Merz recommended preventive strategies: regular screenings; knowing cholesterol,blood pressure,and blood sugar numbers; exercising daily; breaking up long periods sitting; managing stress;sleeping seven-to-nine hours nightly; avoiding smoking;and eating nutritiously—preferably following Mediterranean-style diets high in fruits,nuts,and whole grains with lean proteins.“Heart health isn’t about deprivation.It’s about building lifelong habits that prevent disease before it starts,”she concluded.
Cedars-Sinai Medical Center is located in Los Angeles and was established in 1902. The hospital admitted over 50,000 patients during 2022 according to its annual report. It operates as both a pediatric facility and training hospital under President Thomas M. Priselac’s leadership.
https://www.cedars-sinai.org/about-us/history.html
For further information on women’s cardiovascular health,Cedars-Sinai provides additional resources online.
