Issue 35  | May 20, 2026

Heart disease is the leading cause of death in women.
Yet many midlife women do not have a clear picture of their cardiovascular risk.

 

Key factors that shape cardiovascular health—like pregnancy history, menopause, and hormonal transitions—are often overlooked or underweighted in traditional risk models. As a result, many women move through midlife without a clear understanding of how their risk is changing or what to do about it.

 

We spoke with cardiologist Amy Ahnert, MD, Director of the Women’s Heart Program at Atlantic Health Morristown Medical Center, about what she is seeing in midlife women and where the biggest gaps in awareness and care still exist.

 

Amy Ahnert, MD is a non-invasive cardiologist specializing in women’s heart health. Her work focuses on helping women understand and navigate cardiovascular risk across different stages of life, including menopause, pregnancy, and midlife transitions.

 

She is particularly interested in the ways women’s cardiovascular risk factors are often overlooked or underestimated in traditional models of care. Her clinical and research work focuses on sex-specific risk factors, cardio-obstetrics, prevention, and individualized decision making around treatment options, including hormone therapy.

 

Dr. Ahnert believes women deserve care that looks beyond a narrow lens and considers the broader realities shaping health, including mental health, caregiving responsibilities, hormonal transitions, and social influences.

 

A: Menopause transition is a time of increased heart disease risk for women. During menopause, the loss of estrogen leads to several metabolic and vascular changes that culminate in increasing cardiovascular risk.

 

What happens in a woman’s body during menopause transition? Increased blood pressure, increased LDL cholesterol (bad cholesterol), weight gain, sleep disturbances, and stiffening of the arteries can occur.

 

Unfortunately, this is the perfect storm of factors that make women more vulnerable to heart disease.

 

A: We used to think that preeclampsia and gestational hypertension only affected a woman during or shortly after her pregnancy.

 

We now know that adverse pregnancy outcomes, including preeclampsia, gestational hypertension, gestational diabetes, preterm labor and small for gestational age babies place women at future risk of cardiovascular disease.

 

Many studies have shown that preeclampsia leads to 2–4 times increased risk of heart disease and stroke.

 

We also know that not all preeclampsia is created equal; the more severe and more premature the presentation, the higher the risk.

 

A: The idea that “women are from Venus and men are from Mars” extends to cardiovascular health as well.

 

Despite being the leading cause of death, heart disease in women remains underrecognized, underestimated, underappreciated, and often misunderstood.

 

Women are unique, and so are their hearts.

 

The differences between men and women are apparent across almost all aspects of heart disease. Women are more likely to present with atypical symptoms of heart disease, more likely to have unique risk factors, more likely to have worse outcomes, and less likely to receive guideline-validated treatments.

 

Women have historically been underrepresented in research studies, and there remain significant knowledge gaps in fully understanding the spectrum of heart disease in women. Luckily, these trends are changing.

 

Women can no longer be viewed simply as small men. Our biology is much more complicated than just our smaller size.

 

A: The foundation of heart health is prevention.

 

Women need to hear: “It’s not selfish to take care of yourself.” Women tend to care for everyone else around them and prioritize their health and wellness last.

 

Women need to learn not only what is a heart-healthy diet and what kind of exercise they need, but how to put that knowledge into action. Women are often time-starved, and they need partners in their doctors to help find solutions for healthy living.

 

In addition, the importance of sleep and mental health and wellness cannot be understated. Untreated anxiety, depression, and PTSD increase a woman’s cardiovascular risk.

 

Women need to seek out health care experts who understand heart health in women. Understanding how stages of life affect your heart gives you the opportunity to take action, and that knowledge can make a real difference.

 

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