September 2026. More specifically the week of September 21 to 27: it's Heart Week, or International Heart Week, call it what you want. And we need to talk. Actually this is the subject that everyone needs to talk about.
We talk a lot about inequalities between women and men. Pay, mental load, access to reproductive care. But there is another one that is deadly, this one: inequality when it comes to heart disease.
Breaking news: cardiovascular diseases are the leading cause of death in women worldwide and that is even before breast cancer. In Belgium, they account for 31% of deaths in women. 31%. And yet, when we talk about heart disease, in our collective imagination, we picture it as a man's disease.
The result is pretty grim: women seek care later, are diagnosed more slowly, and are statistically less likely to receive the right emergency treatment. And of course this is yet another consequence of a patriarchal medical system that has for too long ignored the specificity of our female bodies.
A similar heart obviously, but not an identical one
Biologically, a woman's heart works like a man's. But it is, generally speaking, smaller with finer arteries, and it may respond differently to certain risk factors. As a result, cardiovascular diseases could develop in a more gradual way and be harder to detect.
We are obviously not going to see these differences as an inherent fragility but more as a difference that should have been taken into account much earlier in research, in medical education. A small reminder list of everything that has not worked for decades:
- healthcare providers not always trained to recognise the warning signs in women
- a diagnosis that still too often comes too late
- treatments that are not always appropriate, or insufficient
- a disease that presents differently than in men
- more complex interventions, as female arteries are finer and more fragile
- a medical research that has long excluded women from its studies
Symptoms that are hard, even for us, to recognise
The classic image of a heart attack is a man collapsing with a sharp pain in his chest. Good news (?!?), in women, it can look like that too. But in most cases, it... differently. You can find here a short list of things not to dismiss:
extreme and unusual fatigue, nausea, dizziness, pain in the back, neck or jaw, shortness of breath without particular effort, palpitations.
All of these sensations are unfortunately also associated with stress. And that is precisely the problem. You remember "It's all in your head, dear... It's stress, dear..."? But as you can imagine, this diagnostic delay has pretty disastrous consequences. In this situation, every minute counts and if treatment is delayed, cardiac damage can set in more deeply.
Life stages to watch more closely
Female cardiovascular risk is unfortunately not uniform, that would be too easy. It evolves with the hormonal stages of life, but not only that.
For example, hormonal contraception can increase the risk of blood clots, especially when combined with smoking, high blood pressure or diabetes. In women over 35, the combination of smoking and the pill can multiply the risk of heart attack by 30.
Certain complications typical of pregnancy, such as pre-eclampsia, gestational diabetes, high blood pressure, can already signal an increased cardiovascular risk in the long term, even after delivery. Regular follow-up after pregnancy is recommended but unfortunately not always offered.
Finally, menopause marks the drop in oestrogen, and that drop also has its little effect on our heart. On top of that, we can sometimes add an increase in cholesterol, rising blood pressure and abdominal weight gain. All of these... can also play a (bad) role on our heart. Comprehensive cardiovascular check-ups are therefore recommended around the age of 50... and beyond.
An inequality that is biological but also... systemic
Women are also more frequently exposed to precarity, single-parent families, unstable employment, isolation, chronic illness. All of this has an effect on access to care and therefore reduces access to prevention.
Worse, heart attacks in women under 50 are on the rise, which shows us that there is still work to be done.
So what do we do?
First of all, it's great, you're here reading this article. And to make it simple to remember here is a short list of points to keep in mind (and yes, we're repeating ourselves!):
- Listen to your body especially if you feel an unusual fatigue. It is rarely nothing.
- Don't downplay your symptoms (!)
- Know your medical history because things you might not think about could be risk factors.
- Get a cardiovascular check-up, especially from the age of 50.
- Aaaand talk about it around you. Talk to mum, to auntie, to sis.
Knowledge is power!
Source: Ligue Cardiologique Belge, campaign "Le cœur des femmes 2026"
Picture: paul campbell for Unsplash
Picture: paul campbell for Unsplash
