Women’s heart disease: different risks, different care

Watch this story about how our Women’s Heart Center helped one woman born with a heart defect overcome obstacles and deliver healthy children.

This National Women’s Health Week and month is a great time to recognize that an estimated one in five women in the United States dies of heart disease each year, making it the No. 1 cause of female deaths.

When it comes to heart disease, men and women are wired differently. Women often experience unique and subtle symptoms that go unnoticed and put them at risk for heart disease and death.

That’s why University Health launched its Women’s Heart Center in May 2025. The center, located at 2833 Babcock Road, is the first in South Texas exclusively devoted to preventing, diagnosing and treating the special cardiovascular conditions that can lead to heart disease in women of all ages.

“Heart disease isn’t one-size-fits-all,” said Dr. Ildiko Agoston, the founding director of the Women’s Heart Center. “Women deserve care that recognizes those differences throughout every stage of life.”

Different risk factors

Heart attack symptoms are a prime example of why diagnoses and time-sensitive treatment for women are sometimes delayed. Men frequently arrive at emergency rooms with obvious chest discomfort, shortness of breath and pain shooting down their arm. Women may experience some of those same symptoms, but their warning signs can also be more subtle: nausea, fatigue or indigestion.

Men more commonly develop large artery blockages that are easy to see on imaging scans, while women are prone to damage in the small blood vessels that can be overlooked. A woman is also more prone to heart problems triggered by stress.

Hormonal changes and pregnancy

Pregnancy and menopause are accompanied by hormonal changes that can also affect a woman’s heart.

With pregnancy a mother’s blood flow can increase 30-50% to help the fetus grow, and their heart rate increases significantly. The physical changes can trigger high blood pressure and preeclampsia that place the mom at higher risk for kidney damage as well as stroke and heart disease later in life. Gestational diabetes is another serious condition that can develop during pregnancy. It triggers higher blood glucose levels and increased blood vessel inflammation that tax the heart.

“I joke with my patients that pregnancy is like a stress test,” Dr. Agoston said.

Menopause and heart risks

Years later when a woman’s body changes again during menopause, they produce lower amounts of estrogen needed to help maintain healthy blood vessels and the so-called good cholesterol. A woman may notice higher blood pressure, increased cholesterol levels and weight gain – all factors that raise their risk for cardiovascular disease.

How should women protect themselves?

To protect their hearts, Dr. Agoston recommends all women by age 21 meet with a primary care doctor for a heart risk assessment that includes cholesterol and blood pressure checks. They should continue annual checkups that include a discussion of their family cardiovascular history and healthy lifestyle choices.

“If we educate our community, women will feel empowered to ask questions when they see their doctor – not just when they are sick, but before they become sick,” she said.

Our website has more information on how the Women’s Heart Center is helping women protect their hearts. Take the Heart Health Risk Assessment to understand your heart health or the Prenatal Health Assessment to better plan for a safe pregnancy.