Fewer U.S. women these days are aware that heart disease is the number-one threat to their lives -- especially younger and minority women, a new study finds.
Historically, heart disease was seen as a "man's disease," partly because men tend to suffer heart attacks at a younger age than women do. Yet heart disease is the top killer of women in the United States -- causing about 300,000 deaths in 2017, according to the U.S. Centers for Disease Control and Prevention.
In 2004, the American Heart Association (AHA) launched an education campaign called Go Red for Women. That effort, along with others, seemed to raise women's awareness of heart disease. AHA surveys showed that in 2012, more U.S. women were aware that heart disease is the leading cause of death, compared with the late-1990s.
That progress, however, seems to be reversing.
In its latest national survey, the association found that only 44% of women knew heart disease is their top killer -- down substantially from 65% in 2009.
The decline was concentrated among women younger than 65, and was greater among Hispanic and Black women than white women.
The "why" is unknown, but the findings should be a call to action, said Dr. Mary Cushman, the lead author on the report.
Primary care doctors need to stress that heart disease prevention starts at a young age, and it's just as important for women as for men, said Cushman, a professor of medicine at the University of Vermont College of Medicine.
But, she added, that message needs to go out through other channels, too -- from local community groups to social media campaigns.
"We need to meet people where they are," Cushman said. That's particularly true for young and minority women, who may be less likely to have a regular source of health care.
Dr. Nieca Goldberg, a cardiologist at NYU Langone Health in New York City, agreed.
What worked in reaching women in the past may not be working well now, Goldberg said. "We have a whole new generation of young women now," she noted. "And our target audience is a diverse group. We need different ways to reach them."
Goldberg was "disheartened" by the findings, but not surprised. "I'm seeing young patients who tell me, 'I didn't think women got heart disease,'" she said.
They also typically see heart disease as "an older person's disease," Goldberg added.
Yet many young Americans already have risk factors for heart disease, she pointed out -- including obesity, high blood pressure and type 2 diabetes.
The study was published online Sept. 21 in Circulation. It compared results from online surveys the heart association conducted in 2009 and 2019. They included more than 2,500 women in all, aged 25 and older.
Cushman's team found that among women younger than 65, heart disease awareness dropped over the decade. When it came to awareness of heart disease as the leading cause of death, the steepest declines were among women aged 25 to 34 (an 81% decline), Hispanic women (86% decline) and Black women (67% decline).
Awareness of certain heart attack symptoms -- including chest pain, shortness of breath and pain radiating into the arm -- also dipped, especially among the youngest women.
And, overall, only about half of women named chest pain -- the "classic" heart attack symptom -- as a warning sign. "That should be much higher," Cushman said.
She said the waning awareness among Black and Hispanic women is particularly worrisome, since they tend to have more risk factors for heart disease and less access to health care. Enlisting local community groups to spread heart-health messages could help reach those women, Cushman said.
She also stressed that prevention starts early in life. "Don't put it off to the future," Cushman said. "What you do now matters."
That includes not smoking, maintaining a healthy weight, eating plenty of fruits and vegetables, and getting regular exercise. Cushman said research shows that people who are free of major risk factors for heart disease at age 50 have a low likelihood of developing the condition in their lifetime.
The American Heart Association has more on heart disease in women.