Heart Disease in Women

By Kimberley Forthofer, ARNP KalispellOBGYN.com

Coronary heart disease is the number one cause of death and disability for women in the United States.   Coronary heart disease can lead to myocardial infarction (MI), stroke, and sudden death.  Approximately 1 in 3 women over the age of 65 will be affected by heart disease.   Several risk factors for heart disease exist and include a family history of cardiovascular disease, being overweight or obese, smoking, uncontrolled high blood pressure, elevated blood glucose and diabetes, and elevated cholesterol levels.

Overweight and Obesity

Overweight and obesity leads to elevations in blood pressure, blood glucose levels and cholesterol levels.  To reduce the risk of cardiovascular disease women should strive to incorporate a healthy diet, which is low in saturated fat and cholesterol and participate in regular exercise of at least 30-60 minutes most days of the week.

It is recommended by the United States Preventative Services Task Force (USPSTF) that women undergo cholesterol screening starting at age 45; though, often checking cholesterol levels far sooner is warranted if you have any risk factors.

A reduction in as little as 5-10% of body weight can improve cholesterol and blood glucose levels.

Talking with your medical provider can help you to identify realistic goals for healthy weight loss and provide guidance on starting an exercise and activity regimen.  Even as little as 10 minutes a day of physical activity can improve cardiovascular health.


According to the Centers for Disease Control (CDC), nearly 20% of Montanans smoke cigarettes on a daily or near daily basis.  Despite our increasing knowledge of the dangers of smoking, nearly half of Montanans who smoke are under the age of 45.

Smoking introduces toxins to the bloodstream, which cause inflammation and damage to the inner walls of our arteries leading to artherosclerosis and weakening of the vessel walls.

Quitting smoking can reduce the risks of heart disease in as little as 1-2 years.  There are many resources available that are free of charge to help with quitting smoking.

Medications are also available to help with quitting smoking, and meeting with your medical provider can assist you in the right approach for quitting smoking.

High Blood Pressure

Uncontrolled high blood pressure is recognized as the “silent killer” as high blood pressure does not have any symptoms.  Elevated blood pressure, which is similar to a hose on full blast, causes increased pressure within the arteries and heart.  This can lead to damage and weakening of the muscular arterial vessels and walls of the heart.

Overworking the arteries and cardiac muscle can lead to heart failure, MI, and stroke.   It is important to see your provider every year for routine care and have your blood pressure evaluated.

Simple lifestyle changes such as limiting salt intake, caffeine and alcohol reduction, increasing exercise, and weight loss can help to reduce blood pressure.

Diabetes and Elevated Cholesterol

Similar to high blood pressure, uncontrolled blood sugar (glucose) leading to the development of diabetes mellitus type 2 and high cholesterol do not necessarily make you feel unwell.  Women during their childbearing years often have a lower risk of heart disease; however, following menopause the risk increases.

The reduction in the risk of heart disease for younger women is obliterated, however,  if she has a diagnosis of diabetes.  Uncontrolled blood glucose levels and elevated cholesterol lead to plaque build-up within the arteries, which is a major contributing factor in the development of heart disease.

This slow process of plaque build-up can start in childhood and can rapidly progress in some in their 20s, while for others does not become a risk until they have reached their 50s or 60s.

Risk factors for high cholesterol and diabetes mellitus type 2 include a family history of diabetes and high cholesterol, being overweight, those individuals of black, American Indian, Asian American, and Hispanic race, and those over the age of 45.

Additionally, women with a history of gestational diabetes and polycystic ovarian syndrome are at increased risk for the development of diabetes and should have an annual fasting glucose and consider a hemoglobin A1C level, which is an estimate of fasting blood sugar over a 90 day period.

Heart disease is attributable for a quarter of all deaths for women in the state of Montana.  Reduction in heart disease can start with a commitment to improving diet, increasing physical activity, and quitting smoking.

Make a plan for annual screening of your weight and blood pressure, as well as discussing with your practitioner your individual and family medical history, which may identify risk factors warranting evaluation of your cholesterol and blood glucose levels.

Prevention and early treatment is the answer to reducing the complications and premature death caused by heart disease.


**Kimberley Forthofer, ARNP joined Kalispell OB/GYN in July of 2013.  She was raised in Whitefish and returned to the Flathead Valley after working for 4 years as a primary care provider in Idaho.  She offers a wide range of experience in primary care as well as women’s health and her clinical experience includes both acute and chronic care.  She and her husband, Joe, have two children and have enjoyed getting back to the outdoor recreational opportunities that Montana offers.