The Stat Women Can’t Ignore: Heart Disease Is the Real Threat
By Abigail DeVries, MD
One in three women will die of heart disease, but only 1 in 43 will die of breast cancer.
Heart Disease 101
February is National Heart Month. Although heart disease is the leading cause of death in women (men, too!), it often doesn’t get as much attention as cancer. When we say “heart disease”, we are often referring to coronary artery disease, or stiffening and narrowing of the blood vessels that supply the heart, leading to angina or heart attacks. Heart disease can also refer to abnormal rhythms of the heart, such as atrial fibrillation, or heart failure, where the heart is no longer able to pump efficiently enough.
As you move into midlife, it’s important to know your own personal risk. And, if you had a first degree relative diagnosed with heart disease in their 40s or 50s, you want to get evaluated even sooner.
Although heart disease is the leading cause of death in women (men, too!), it often doesn’t get as much attention as cancer.
Dr. DeVries & Sabia Health
I am a family physician with 20+ years of experience and a certified menopause society practitioner. In 2025, I opened Sabia Health, a direct primary care practice especially for women in midlife. My goal is to ensure women feel their best now and age healthy and strong. (To learn more about what a direct primary care practice is, see here: https://dpcnation.org/).
At Sabia Health there are some newer tests that have not yet become standard of care that I order for all of my patients:
- Fasting insulin to glucose ratio: let’s me know if your body is already having trouble metabolizing sugar before your blood glucose levels rise.
- hs-CRP: a marker of vascular inflammation–higher levels indicate higher risk of cardiovascular disease. Excess weight is the biggest driver.
- Lipoprotein (a): genetically determined, independent risk factor for cardiovascular disease. There are new drugs emerging that will be able to target this cholesterol.
- Apolipoprotein B: a more specific marker of plaque-forming cholesterol than LDL alone, impacted by diet and exercise.
What to Check and When
Everyone should have their blood pressure checked annually, because elevated blood pressure is the biggest risk factor for heart disease.
And, depending on family history and the results above, I often also order a coronary calcium score (CAC). Measured via low-dose CT scan, a CAC can show early vascular disease and help determine whether more aggressive therapy is recommended.
You Know Your Risk Level... Now What?
Once you’ve determined what your risk is, here are the main areas of focus for decreasing your risk:
- Blood Pressure: If you have high blood pressure, work with your doctor to get it into a normal range. If you had high blood pressure during pregnancy, it is very likely to return as you age and it is important to monitor at least yearly.
- Nicotine Exposure: If you smoke or vape, figure out a plan to quit as soon as possible. There are medications that can help.
- Cholesterol levels: If your cholesterol is elevated, work to decrease it through diet and exercise. If your doctor thinks it is in the danger zone, don’t be afraid to start medication to bring it down.
- Blood sugar and insulin resistance: cutting back on added sugars in your diet, getting regular physical activity, building muscle and managing stress all improve insulin resistance and blood sugar control. There are many safe and effective medications that also help.
- Hormones: If you are a woman in perimenopause or early menopause, consider Hormone Replacement Therapy. And if you hit menopause early (younger than 40) or have your ovaries removed before age 50, taking hormones until the average age of menopause (52), is considered standard of care.
Healthy lifestyle habits are key and it’s never too early or too late to start!
- Get 2 1/2 hours of moderate physical activity per week
- Lift weights 2-3 times per week
- Add more fruits, vegetables and whole grains to your diet while decreasing sugar and fried foods. Aim for 25+ grams of fiber and 80+ grams of protein per day
- Prioritize good sleep
- Manage stress–the goal is not to eliminate stress but to be better able to manage it through medication, breathwork, prayer and exercise. Although there is more than enough toxic stress to go around right now and we all would like to avoid that, I also believe that a life of meaning will naturally include some healthy stress. Teaching our bodies how to best respond to and recover from good and bad stress will help improve inflammation, blood pressure and insulin resistance.
Final Thoughts
And finally, I want to point out that what we think of as typical heart attack symptoms–sudden left-sided chest pain radiating down the arm with sweating and shortness of breath–is not necessarily “typical” for women. Men often have one large blockage that suddenly cuts off blood supply to an area of the heart.
In contrast, women often have narrowing that is more spread out, causing signs to be more subtle. Women still most often present with some type of chest pain, but they also may have: anxiety, shortness of breath, nausea, vomiting, upset stomach, pain in the shoulder, back or arm, unusual tiredness and weakness. If you or someone you love has some of these symptoms and risk factors for heart disease, they should get checked out right away.
Despite being so common, there is no inevitability about developing heart disease, even with a strong family history. We are learning more every day about how to prevent or delay heart disease. You can take action today! For more information, visit heart.org.
You can find me at https://www.sabiahealthnc.com or on socials @sabiahealthnc
I want to hear from you! What healthy habits have you committed to in 2026 that will reduce your risk? What questions do you have?
About Dr. Abigail DeVries. Dr. DeVries is a board-certified family physician with over 20 years of experience caring for patients, leading clinical teams, and shaping health systems across North Carolina and the U.S. She is also a menopause society certified practitioner.
Fluent in both English and Spanish, she combines rigorous evidence-based practice with a focus on lifestyle, hormonal, and preventive care that makes sense of what her patients are experiencing—especially during midlife, when so many women feel dismissed or overlooked.
Sabia Health is a direct primary care practice especially for women ages 40 to 60.
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