You know what a pink ribbon signifies. Breast cancer, right? Now what about a red dress?<\/p>\n
Did you come up with heart disease? No? Don\u2019t worry: You\u2019re not alone.<\/p>\n
Heart disease is the leading killer of cisgender American women \u2014 and that trend shows no signs of slowing. New projections estimate<\/a> the share of US women with heart disease will keep rising through 2050, affecting more than 22 million women, with the sharpest increases among younger women ages 20 to 44. Heart attacks are already becoming more deadly<\/a> for adults under 55 \u2014 again, particularly for younger women who don\u2019t have the traditional risk factors. The prevalence and deadliness of heart disease for women specifically has been a public health problem for a long time, and it\u2019s getting worse.<\/p>\n Yet awareness of that crisis seems to be shrinking, not growing. An American Heart Association survey published in 2020 found<\/a> that US women\u2019s awareness that heart disease is the No. 1 cause of death and that women can experience unique heart symptoms fell sharply, from 65 percent in 2009 to 44 percent in 2019. Knowledge about the symptoms of a serious cardiac event also declined. More recent data isn\u2019t much more encouraging: In a 2025 survey<\/a> of cardiologists by the Women\u2019s Health Alliance, 84 percent said that they had treated a female patient whose heart condition was misdiagnosed by another doctor.<\/p>\n In that 2020 AHA survey, a growing number of women thought it was breast cancer, not heart disease, that killed the most women. Cardiologists look at their oncologist colleagues with a hint of envy.<\/p>\n \u201cI\u2019m just jealous of them. They\u2019ve done a good job at getting out the message. We have not,\u201d said Dr. Martha Gulati, a cardiologist at Houston Methodist Hospital.<\/p>\n It\u2019s not for lack of trying. Groups like the AHA have made admirable efforts to raise awareness, including The Heart Truth campaign<\/a> and Go Red for Women<\/a>. But the stagnating progress suggests that a new approach might be needed. Gulati said she wears a red dress pin at work all the time, but her own patients rarely know what it signifies.<\/p>\n \u201cThese are people that are living with heart disease, and they don\u2019t even know what it means,\u201d Gulati said. \u201cThe problem is that we are not reaching women. It is not resonating with women\u2026 I actually really believe that a rebrand is required.\u201d<\/p>\n Why it\u2019s been so hard to make women\u2019s heart health a priority<\/p>\n What makes the lack of awareness about women\u2019s heart disease so perplexing is the fact that scientists have known about their unique risk for years.<\/p>\n In the 1980s and 1990s, researchers first noticed that while men were seeing marked improvements in outcomes from heart disease and heart attacks, women were not<\/a>. In the years since, scientists have found there are important physiological changes that put women at unique risk for heart disease and could lead to them experiencing different symptoms and pathologies that physicians in the mid-20th century failed to notice. Researchers have been racing to catch up and improve our collective knowledge ever since.<\/p>\n Sign up for the Good Medicine newsletter<\/p>\n Our political wellness landscape has shifted: new leaders, shady science, contradictory advice, broken trust, and overwhelming systems. How is anyone supposed to make sense of it all? Vox\u2019s senior correspondent Dylan Scott<\/a> has been on the health beat for a long time, and every week, he\u2019ll wade into sticky debates, answer fair questions, and contextualize what\u2019s happening in American health care policy. Sign up here<\/a>.<\/p>\n But they have been working at a disadvantage \u2014 starting with the preclinical animal experiments that often set the stage for later breakthroughs. According to a June 2024 report from the AHA and McKinsey<\/a>, 72 percent of animal studies from 2006 to 2016 used only male mice. In human trials from 2010 to 2017, just 38 percent of participants were women; post-menopausal women, who are at the most risk from cardiovascular disease, had an even lower participation rate (26 percent). Even after all of this time, according to a 2025 study in the American Heart Journal<\/a>, there have still not been any randomized controlled trials for a number of heart conditions that disproportionately affect women.<\/p>\n At the same time, the health system has failed to make women\u2019s heart health a priority. According to the AHA\/McKinsey report, less than one in four primary care doctors say they feel well equipped to gauge cardiovascular disease risk in women. The problem starts in medical school: A 2024 survey of medical schools in the US and Canada found that more than 70 percent did not feature any gender-specific content in their curriculum.<\/p>\n If a woman develops heart disease, the way it functions can look different than it does in a man. Unfortunately, this can confound doctors who haven\u2019t received proper training and lead to the worst outcomes. For example, women are more likely<\/a> to experience blockages in their small arteries, but not necessarily in the large arteries that are usually the focus for clinicians and for most diagnostic tests. (And in an emergency, EKGs can sometimes be unreliable due to incorrect placement near breast tissue.)<\/p>\n \u201cWe have to do better. I think it has to come from training up. I can only teach so many medical students, but the ones I teach, I try to integrate it from the start,\u201d said Dr. Harmony Reynolds, a cardiologist at NYU-Langone who has co-authored influential research<\/a> on women and their unique experience of heart issues. \u201cI think that has to be true for paramedics, for nurses, for doctors, for every level of the medical establishment and patients.\u201d<\/p>\n And if the system is biased from the start, it puts patients at a huge disadvantage when it comes to understanding their own bodies and advocating for themselves. Women are almost twice as likely as men to report that their chest pain was likely the result of stress rather than an underlying heart condition. Women of color are at higher risk<\/a> and less aware of heart disease than white women.<\/p>\n And so, despite some real progress in science\u2019s understanding of how heart disease manifests in women, women are still disproportionately dying. From 1990 to 2011, young women saw only marginal improvements<\/a> in their mortality rates from coronary artery disease. As documented in the AHA survey, awareness among the general public fell off in the following decade.<\/p>\n How can we raise heart disease awareness among a new generation of women?<\/p>\n Part of the problem is it\u2019s always hard to convince people to care about their long-term health. Young people think they\u2019re going to live forever. Even as the evidence grows that more young women are at risk and even suffering catastrophic outcomes, many people still think of heart disease as a problem for older people \u2014 particularly for older men. Trying to frighten people into caring more about it, even if they should be worried, does not seem to be having the desired effect.<\/p>\n Dr. Mary Cushman, a cardiologist at the University of Vermont who co-authored the 2020 AHA study on public perceptions of women and heart disease, said she recently spent a day walking around campus, trying to engage students on heart disease.<\/p>\n \u201cI just feel like younger people aren\u2019t thinking deeply about these topics. With the students that we talked to, it was really apparent that they just didn\u2019t know,\u201d she said. \u201cYou look at wonderful programs, like Go Red for Women, but where are they? Are they in the right places? I don\u2019t know. I don\u2019t know the answer.\u201d<\/p>\n