Heart disease is the number one killer of women, yet most women don’t know at what age heart-related health screenings should begin, according to a new nationwide survey. The American Heart Association recommends women be screened for risk factors like obesity and high blood pressure starting at age 20, but 60 percent of women in the survey thought these tests weren’t needed until after age 30.
Here’s the reality: Women of all ages should be talking with their doctors about heart health, even if it’s just at their annual physical, says Swathy Kolli, M.D., cardiologist at the Orlando Health Heart Institute’s Women's Cardiac Center.
Starting at age 20, they should also have their blood pressure and their body mass index (BMI) measured at every doctor's appointment, and should have their cholesterol checked (via a blood test) at least every four to six years, according to American Heart Association Guidelines.
So why are so many women in the dark? The December 2016 Orlando Health survey included 1,062 women from across the country, and found that only 8 percent of respondents thought heart screenings for otherwise healthy people without known risk factors should begin at some point in their 20s. On average, women guessed 41 as the right age to start—two full decades later than what’s recommended.
Young women tend not to think about heart disease very much, says Dr. Kolli, because its consequences often don’t become obvious until many years later.
“But the more years you are exposed to risk factors, the higher chances you have of having heart related problems,” she says. “In many women, we start seeing evidence of plaque buildup starting in their 20s, and at some point that’s going to catch up with them.”
If women in their 20s are overweight or have other risk factors, doctors may also recommend more frequent or additional screenings, like a blood glucose test to measure diabetes risk, an electrocardiogram to listen more closely to the heart, or a measurement of their waist circumference.
“The conversations we have with patients are very individualized, and they’ll be different for a woman with high blood pressure versus a pregnant woman with gestational diabetes versus a woman who’s very fit and active,” she says. “But the bottom line is that every single woman needs to be evaluated for risk factors—including things like family history, which may not be obvious just by looking at someone.”
It’s especially important for women to pay attention to heart-disease risk factors, she adds, since heart-related symptoms can be different for women—and often less obvious—than for men.
But screenings are only one part of the fight against heart disease in women, says Dr. Kolli; what’s even more important are the heart-healthy behaviors that can prevent problems in the first place.
“It’s a good time for education—making sure women are eating a heart-healthy diet, not smoking, exercising regularly, and having good cholesterol control,” she says. “We should be having those conversations as early as possible, not waiting 20 years when it may be too late.”