Sven Wombwell
Article by: Sven Wombwell
Estimated 8 minutes read

Heart disease is a range of conditions affecting the heart and blood vessels. It's one of the leading causes of death and affects both men and women. While various factors can contribute to heart issues, knowing what they are can help protect your health. So, what are the leading causes of heart disease in the United States? According to Cleveland Clinic 1, they can include:

  • Coronary artery disease - the narrowing of the blood vessels due to fatty deposits
  • Heart valve disease - which develops in any of the heart's four chambers
  • Heart failure - when the heart doesn't pump enough blood
  • Arrhythmias - Irregular heartbeats
  • Cardiomyopathy - abnormal heart muscle
  • Congenital heart disease - heart problems that occur at birth
  • Atherosclerosis - the hardening of the arteries

Symptoms of Heart Disease

While symptoms can differ depending on the type of heart disease and the individual. According to David Newby, professor of cardiology at the BFH Center of Research Excellence at the University of Edinburgh, 2  some signs that could indicate a heart attack include:

Chest pain

While it's a well-known symptom of a heart attack, many people still don't take it as seriously as they should. Of course, the pain itself is a reason to seek medical attention, but it can often come with a tightening of the chest that feels heavy or constricting and may cause you to feel ill. 

Arm pain

Pain moving down the arm - primarily the left arm - can signify a heart attack. It can sometimes move into the neck area as well. 


While sweating on its own may not be a concern, if it occurs with other symptoms, such as chest pain, it can be a sign of something more serious.


It could be a sign of heart failure if you're feeling unusually tired for no apparent reason, such as working late or not sleeping.

Jaw or back pain

Although it's not a classic symptom of a heart attack, pain in the jaw or back can be a sign, especially in women, who may have symptoms that vary from those that are more well-known. 

Breathing difficulty

Angina can sometimes cause a choking or tightening feeling in the throat, which may be a sign of heart problems.

Fluid retention

Swollen ankles have many causes, including medications and standing all day, but they can also indicate heart issues and should be checked by your health practitioner.

Heart Disease Risk Factors

The chances of developing heart disease can depend on many things, including problems with blood vessels, oxygen flow, the flow of blood, heart rhythm and heart damage.

While some issues are out of your control and can be genetic, many are manageable through behavior and healthy lifestyle choices. 

According to the World Health Organization, 3 most cardiovascular diseases are preventable by addressing risk factors like smoking, poor diet and obesity, physical inactivity and alcohol.

Things that can increase your risk of developing heart disease include:

  • High blood pressure
  • Diabetes
  • High cholesterol
  • Poor eating habits
  • Obesity
  • Smoking
  • Sleep habits
  • Stress
  • Excessive alcohol consumption
  • Lack of physical exercise
  • Age

What are the Leading Causes of Heart Disease in Women?

Men and women don't always present the same signs of heart disease, so paying attention to your health and not ignoring symptoms that something may be wrong is essential.

One study 4 reviewed the symptoms routinely experienced by women who have had heart attacks and found they didn't have the typical symptoms often described by men, including chest pain. Instead, the study reported symptoms that included unexplained fatigue, high stress and feelings of anxiety along with disturbances in sleep patterns.

The most surprising findings were that eighty percent of the women reported the symptoms had occurred over the months leading up to a heart attack. They also found these symptoms were commonly dismissed as being related to menopause, anxiety or depression.

Women are more likely than men to have heart attack symptoms unrelated to chest pain, such as:

  • Neck, jaw, shoulder, upper back or abdomen discomfort
  • Breathlessness
  • Sweating
  • Pain in one or both arms
  • Nausea or vomiting
  • Lightheadedness or dizziness
  • Chronic Fatigue
  • Heartburn or indigestion

Menopause and Heart Disease

It's no secret menopause can cause some miserable symptoms. Between hot flashes, night sweats and mood swings, it can make women feel like strangers in their own bodies. 

As a woman's estrogen and progesterone production slows leading up to and after menopause, the risk of CVD increases. Estrogen protects the arteries of a woman's heart in many ways, including reducing the build-up of fatty plaque. So, after menopause, women are at an increased risk of heart and circulatory disease due to low hormone levels.

When considering the leading causes of heart disease, menopause isn't usually recognized. But due to the narrowing of the arteries and the decline in hormone levels, it should be considered a leading cause of heart disease. Without hormone replacement therapy (HRT) and the protection it offers, the risk continues to increase with age, so it's essential to be aware of changes in the body and symptoms that can include:

  • Becoming pale
  • Difficulty breathing
  • Dizziness and lightheadedness
  • Ingestion
  • Nausea and vomiting
  • Fainting
  • Jaw pain
  • Back pain
  • Neck pain
  • Cold sweats

These symptoms can easily be confused with other health issues not recognized as symptoms leading to a heart attack, which is why it's so important to be aware of them.

Lifestyle Factors to Help Prevent Heart Disease

Heart disease comes in many forms, and while certain risks are out of our control, there are many things we can do to stay proactive about our heart health. They include:

  • A healthy diet. Ditch processed foods, sugar, and white flour for whole grains, vegetables, and fruits. Whole foods fuel our bodies and keep blood vessels clear, helping us to maintain a healthy heart.
  • Get moving. Staying active is not only good for the heart, but it also helps keep stress at bay. Find an activity that gets you moving, such as tennis, dancing or hitting the gym. A combination of cardio and strength training is the best way to keep all your muscles strong and healthy, including your heart.
  • Don't stress out. Stress can harm our health and increase blood pressure leading to damaged arteries. A few things that can reduce stress include physical exercise and activity, meditation and hobbies.
  • Quit smoking. According to the National Heart, Lung and Blood Institute, 5 Smoking damages about every organ in the body and plays a big part in developing heart disease. 
  • Regular practitioner visits. By visiting your health professional regularly, you can be proactive and avoid health issues before they get serious. It can be essential to be your own advocate by being honest about what's going on with your health.

TRT and Heart Disease

Some men can be concerned about testosterone replacement therapy (TRT) and whether it can put them at risk of a heart attack. The concern arose from the steroid abuse by bodybuilders and athletes and using estrogen blockers - not from medical TRT. 

Testosterone replacement therapy (TRT) is a medical treatment that involves optimizing testosterone in men who have symptoms of low T. Despite concerns about its potential negative effects on the cardiovascular system, research 6 suggests that TRT does not cause heart disease in men. In fact, studies 6 show that TRT may have beneficial effects on cardiovascular health by reducing the risk of cardiovascular events such as heart attacks and strokes.

One important consideration is that low testosterone is a risk factor for heart disease. If you naturally have low testosterone, you are more likely to have a heart attack. Conversely, studies show 7 that if you have a naturally higher testosterone level, you are at a decreased risk for heart disease.

When considering what are the leading causes of heart disease, TRT for men over 40 makes sense. As a part of a healthy lifestyle, TRT can help reverse heart risk factors such as obesity, type 2 diabetes, stress and poor sleep. It can also increase motivation, energy levels and libido (sex is great for heart health, by the way).


Knowing what are the leading causes of heart disease and understanding how lifestyle choices can offer a big impact is powerful. While it may not be able to be cured, it can be effectively controlled with diet, exercising regularly and, if necessary, additional medical procedures like TRT and hormone replacement therapy (HRT). Being proactive with your health can keep you and your heart healthy and strong for years to come.


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