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Why Women’s Heart Health Deserves More Attention

While cardiovascular disease is often perceived as more of a male concern, it remains a major threat to women’s health. In fact, heart disease and stroke are the leading cause of premature death among women in Canada.[i] Additional research and education for female-specific strategies are essential.

A 2025 study from the Sunnybrook Health Sciences Centre in Toronto found that poor cardiovascular health status was associated with a higher risk of future cardiovascular disease events in both women and men, but the impact appeared stronger in women.[ii] Specifically, poor cardiovascular health was linked to an almost fivefold higher rate of cardiovascular events in women, compared to a 2.5fold higher rate in men.

The focus for cardiovascular health and prevention has often targeted men, in part because heart attacks have traditionally been viewed as a male issue.

This study highlights the need for women to assess their cardiovascular health status and work on preventable lifestyle strategies. Factors such as smoking, poor sleep, and unhealthy diets can all play a negative role in cardiovascular health.

The Sunnybrook study references the following key strategies as important factors in preventing cardiovascular disease. The American Heart Association refers to these as Life’s Essential 8 for women.[iii] They include:

  • Eat better: Focus on a diet rich in fruits, vegetables, nuts, legumes, whole grains, and lean proteins.
  • Be active: Exercise regularly. Engage in weekly activities that include 150 minutes of moderate-intensity or 75 minutes of vigorous aerobic activity per week. Good examples include brisk walking, swimming, or cycling.
  • Quit tobacco: Stop smoking and vaping, and avoid second-hand smoke.
  • Get healthy sleep: Aim for 7 to 9 hours of sleep per day.
  • Manage weight: Maintain a healthy weight with a body mass index (BMI) in the optimal range (18.5–25).
  • Control cholesterol: Evaluate yearly to maintain healthy cholesterol levels.
  • Manage blood sugar: Evaluate yearly to know your numbers for blood sugar levels.
  • Manage blood pressure: Aim for an ideal blood pressure of 120 over 80 mmHg or below.

In addition to these factors, stress reduction is so important. Chronic stress can lead to increased inflammation in the body. When the stress hormone cortisol is elevated, blood pressure and heart rates can increase. Sustained levels of cortisol can cause higher levels of bad cholesterol and blood sugar. In addition, we know that stress can lead to unhealthy lifestyle choices, such as increase in alcohol consumption, smoking, poor diet choices, overeating, and craving sugar. These all increase your risk of developing heart disease.

Oftentimes, it can be overwhelming or even stressful to consider making changes in all these areas. Ideally, begin with the lifestyle strategies that appeal to you. If you like to exercise and have not been as active for a while, start there. Begin by walking every day for at least for 30 minutes. Changing one behaviour often leads to other positive life choices.

Health educators—including your family doctor, naturopathic doctor, physiotherapist, occupation therapist and others—can assist you with your health goals. An individualized treatment plan and counselling can support your overall health status.

Starting at 20 years old, regular screening can begin for blood pressure, blood sugar, and cholesterol levels. Other screening options include looking at additional markers for heart health. These blood tests can be ordered through your family doctor or naturopathic doctor (in accordance with applicable provincial regulations).

A laboratory test called Creactive protein (CRP) measures the level of inflammation in the body. It is used to detect infection and inflammation, and it measures the risk of cardiovascular diseases. This inflammatory marker is not often incorporated in routine yearly screening.

A genetic test called lipoprotein A is another one that can be used for screening overall cardiovascular health. Lipoprotein A is a cholesterol-carrying protein in the blood. It is usually performed only once, as the level is mostly inherited. It is not incorporated with the common testing of cholesterol levels. When lipoprotein A is high, it can mean that there is a greater risk of developing cardiovascular disease. Elevated levels of this lipoprotein can cause cholesterol to build up in artery walls and cause plaques which can lead to potential blockages in the blood vessels.

A homocysteine test can also help identify the overall risk of cardiovascular disease. It measures the level of the amino acid homocysteine in the blood. Higher levels can cause damage to blood vessels, increasing the risk of forming blood clots that can lead to a stroke or cardiovascular disease.

These tests are not often used for screening purposes but can be ordered by your health-care practitioner. Having a conversation with your family doctor or naturopathic doctor about your family history and possible genetic predisposition is recommended to see what tests might be appropriate.

Education about lifestyle factors, developing an individualized care program for heart-health promotion, and regular screening are recommended for women of all ages. Having a health-care practitioner that listens to you and helps you determine your risk is key. Understanding your current health status with yearly monitoring is essential for preventing cardiovascular disease.

Dr. Odessa Gill, ND

Dr. Gill has been in practice for 20 years and is the co-owner of a naturopathic clinic in Bloor West Village, Toronto. She has a focus on stress management, fertility, and hormonal health.

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References

[i]         University of Ottawa Heart Institute. Canadian Women's Heart Health Centre. https://www.ottawaheart.ca/patients-visitors/centres-and-programs/canadian-women-s-heart-health-centre.

[ii]        M. Sud, A. Chaudhry, F. Qui, O. Haldenby, L.C. Godoy, P.C. Austin, I. Roifman, et al. “Sex differences in cardiovascular health status and long-term outcomes in a primary prevention cohort.” JACC. Advances 4, no. 10 pt. 2 (2025): 102108.

[iii]        American Heart Association. Life’s Essential 8™ for Women. https://www.goredforwomen.org/en/know-your-risk/lifes-essential-8-for-women.