Heart disease remains the leading cause of death for women in the United States, claiming more lives annually than all forms of cancer combined. While genetic predisposition and lifestyle factors like diet and exercise are well-known contributors to cardiovascular disease, the unique stressors that women face — rooted in societal pressures and caregiving roles — are often overlooked in discussions of heart health. To effectively combat heart disease among women, we must address the intersections of stress, gender roles and cardiovascular risk.

Stress is a significant risk factor for heart disease, triggering physiological changes that include elevated blood pressure, increased heart rate and heightened levels of cortisol — a stress hormone linked to inflammation and arterial damage. Chronic stress exacerbates other cardiovascular risk factors, such as obesity, diabetes and hypertension. For women, these effects are amplified by societal and cultural norms that disproportionately assign them caregiving responsibilities and emotional labor.

Gender bias in cardiovascular care significantly affects women’s outcomes. Studies reveal that women are less likely than men to receive timely diagnoses or aggressive treatments for heart conditions, even when presenting with the same symptoms. This disparity is partially due to outdated assumptions that heart disease primarily affects men, leading to the under-recognition of symptoms in women, particularly those that are “atypical.” Furthermore, women are often misdiagnosed with anxiety or other non-cardiac conditions, delaying critical interventions.

Bias extends to research as well. Historically, clinical trials for cardiovascular treatments have underrepresented women, resulting in guidelines that may not fully address gender-specific needs. Addressing these gaps requires intentional efforts to include more women in cardiovascular research and develop treatments tailored to their unique physiological profiles.

From a young age, women are often socialized to prioritize the needs of others over their own. This expectation manifests in various ways, from caregiving for children and elderly relatives to managing household responsibilities and supporting partners’ careers. These demands are compounded by professional pressures, as women increasingly balance traditional roles with the expectations of full-time careers.

The “superwoman” ideal — the notion that women can and should excel in all areas of life — places an immense psychological burden on women, often leading to chronic stress and burnout. This societal expectation not only erodes mental health but also directly affects physical well-being, increasing the risk of heart disease.

To mitigate the impact of stress on women’s heart health, we must adopt a multifaceted approach when caring for women with heart disease. This approach includes:

• Challenging gender norms. Public health campaigns and workplace policies should aim to redistribute caregiving responsibilities more equitably, emphasizing the importance of shared domestic duties and equal partnerships at home.
• Supporting care and research on women’s cardiovascular health. Increased funding and attention to gender-specific studies can shed light on how societal factors uniquely affect women’s heart health, paving the way for targeted interventions.
• Improving access to mental health care. Addressing the stigma around mental health and ensuring affordable, accessible care for women can help reduce chronic stress and its physical consequences.

The societal pressures and caregiving roles that women navigate daily are not just stress-inducing; they are life-threatening. To combat the epidemic of heart disease among women, we must move beyond traditional approaches focused solely on diet and exercise. By addressing the root causes of chronic stress and challenging the societal norms that perpetuate it, we can empower women to prioritize their heart health and break the cycle of invisible burdens.

The health of women’s hearts depends not only on individual choices but also on systemic change. It is time to shift the narrative and create a society where women’s health — physical, mental and emotional — is fully supported and valued.