Extreme fatigue, pain that radiates into the jaw, nausea, acid reflux, dizziness and shortness of breath all can be signs of heart attacks in women.

Yet Hispanic women often overlook these worrisome symptoms, which puts them at greater risk of experiencing a heart attack than non-Hispanic White women.

Six in 10 White women in the U.S. are aware of common signs of heart attacks compared with just three in 10 Hispanic women, according to medical experts at the American Heart Association.

This lack of awareness about heart health is very dangerous for Hispanic women.

“Among Hispanic women, 37% are affected by cardiovascular disease, and it’s the leading cause of death in this population,” said Dr. Raymundo Quintana, a cardiologist at UCHealth University of Colorado Hospital.

While cardiovascular disease can be deadly, it’s largely preventable. Many Hispanic women don’t understand that they can make lifestyle changes to dramatically reduce their chances of suffering a heart attack, stroke or another cardiac problem.

To learn more about the impact of heart disease on Hispanic women and to raise awareness of heart health in general, we asked Quintana some of your top questions.

What are the common symptoms of heart attacks? 

Each person may have slightly different symptoms of a heart attack, but these are the most common:

• Anxiety
• Pain in the back or jaw and pain that travels down one or both arms
• Chest pressure, squeezing, aching or burning
• Excessive fatigue or weakness
• Feeling of fullness
• Nausea or vomiting
• Shortness of breath

Do women have different heart attack symptoms than men? 

Yes, women can have different heart attack symptoms than men. And for decades, researchers focused much more on cardiac health in men. So, medical experts know less about women’s heart health.

We do know that women are less likely to seek medical care quickly if they are having symptoms of a heart attack. And it’s vital to get help as fast as possible to reduce damage to the heart.

Here are some symptoms of heart attacks that differ in men and women:

• Men normally feel pain and numbness in the left arm or side of chest, but in women, these symptoms may appear on the right side.
• Women may feel completely exhausted, drained, dizzy or nauseous.
• Women may feel upper back pain that travels up into their jaw.
• Women may feel like they have the flu, heartburn or an ulcer when they’re actually experiencing a heart attack.

Having a healthy heart means your heart efficiently moves blood through your body in a steady rhythm, nourishing every organ. (Learn about exercises you can do to maintain a healthy heart.)

What are the common risk factors for cardiovascular disease in women?

A person’s likelihood of developing cardiovascular disease is closely linked to risk factors.

One of the greatest risk factors for heart problems is being overweight or obese, Quintana said.

‘‘Only about 21% of Hispanic women have a healthy body mass index,’’ said Quintana, who is also an assistant professor of medicine and cardiology at the University of Colorado School of Medicine on the Anschutz campus.

Here are the most common risk factors for heart problems among Hispanic women:

• Obesity: Nearly 80% of Hispanic women in the U.S. are overweight or obese.
• Diabetes: The prevalence of diabetes is higher among Hispanics compared with non-Hispanic Whites.
• High blood pressure: Also known as hypertension, high blood pressure forces the heart to work harder than necessary and damages arteries over time.
• Dyslipidemia: This means having abnormal levels of fats in the bloodstream. It can include having high cholesterol. (Learn about new cholesterol guidelines)
• Metabolic syndrome: Having this syndrome means you have at least three risk factors, including high blood pressure, high blood sugar, high cholesterol, or excess fat around the waist.

Women who are overweight or obese also are at higher risk of developing high blood pressure, diabetes and high cholesterol, all of which increase their chances of getting heart disease, Quintana said.

Why are the risks of cardiovascular disease so high among Hispanic women?

Quintana explained how culture impacts health. Culture shapes beliefs, habits, attitudes, behaviors and perceptions.

In Hispanic communities, women are typically central to the family unit.

“Hispanic women often face many social pressures as the heart of their families, and the expectation to maintain ‘familismo’ — family-centered values — can add to their stress,” Quintana said. “This stress, along with conditions like lupus and symptoms of depression, has been linked to a higher risk of heart disease and atherosclerotic cardiovascular disease.’’

People who have atherosclerotic cardiovascular disease are dealing with the dangerous buildup of plaque in their arteries, which can cause heart attacks. The disease is the leading cause of death and disability worldwide.

Chronic diseases such as diabetes and hypertension, prevalent among Hispanic women in the U.S., exacerbate atherosclerotic cardiovascular disease.

Why should Hispanic women prioritize their heart health?

The answer is simple, Quintana said.

Hispanic women are in great danger if they don’t put their health first. They are used to caring for other people. They need to have more empathy for themselves and take just as good care of themselves as they would for their parents, spouses and children.

Identifying and managing cardiovascular risks as early as possible is crucial for the health and survival of Hispanic women.

‘‘Hispanic women often face a higher burden of risk factors than non-Hispanic White women, and conditions like premature menopause can increase risks,” Quintana said.

How does menopause increase the risk of heart disease?

Menopause marks the end of menstrual cycles. These changes in a woman’s body disrupt the heart.

‘‘Menopause is associated with worsening blood pressure, lipid profiles, insulin resistance, and central adiposity. Hispanic women are more prone to experiencing earlier menopause compared to non-Hispanic women.’’ Quintana said. ‘‘Women should be aware that menopause is a critical window for intensified screening and prevention for cardiovascular disease.’’

He said that researchers are beginning to learn more about connections between menopause and cardiac disease.

‘‘Premature menopause is recognized as an emerging predictor for atherosclerotic cardiovascular disease,’’ Quintana said.

Atherosclerosis cardiovascular disease occurs when fats, cholesterol and other substances accumulate in and along the walls of the arteries.

How do most heart attacks occur?

Most heart attacks occur when a blood clot obstructs a coronary artery.

Medical experts at the American Heart Association reported that 30,676 Hispanic women died from cardiovascular disease in the U.S in 2022, according to the most recent data available.

Why do many Hispanic woman not realize that they are at risk for heart disease?

There’s a common myth among Hispanic women that they are healthier than others.

‘‘Hispanic women sometimes underestimate their heart disease risk due to the so-called ‘Hispanic paradox’ — the idea that Hispanic individuals may have lower disease rates despite higher risk factors. But recent data show that some subgroups (Puerto Rican, Cuban, Mexican) have mortality rates equal to or higher than non-Hispanic White women,’’ Quintana said.

Did the COVID-19 pandemic hit Hispanic women differently, causing an increased risk for cardiovascular disease?

Yes. The pandemic disproportionately affected Hispanic women. Many had to continue working in-person jobs at the beginning of the pandemic, meaning they were at greater risk of getting sick and suffering long-lasting health consequences, including long COVID.

Increased exposure to COVID-19 led to a greater risk of cardiovascular disease among Hispanic women.

“Maternal mortality has risen sharply, especially during COVID-19, increasing from 11.8 per 100,000 live births in 2018 to 28.0 in 2021 — higher than rates in non-Hispanic White women,” Quintana said.

He explained that limited access to health insurance and living in areas with limited educational and health resources contribute to poor cardiovascular outcomes for Hispanic women.

Stress from financial strain and discrimination also leads to higher rates of cardiovascular disease among Hispanic women.

Quintana said the pandemic hit Hispanic communities and Hispanic women hard, thus causing spikes in stress.

‘‘In 2020, Hispanic women’s unemployment rate reached 21%, compared with 9% for non-Hispanic women,” he said.

Why aren’t Hispanic women getting the care they need to help prevent heart disease and heart attacks?

Access to health care is a major challenge among Hispanic women, Quintana said.

Limited access to primary care means Hispanic women aren’t getting vital health screenings.

Key barriers to care include:

• Nearly one in four Hispanic women lacks health insurance. This is the highest uninsured rate in the U.S.
• Language barriers and limited access to medical providers who speak their language mean that people who don’t speak English may not be getting the screenings they need, may not understand their results, or may not follow their doctor’s advice and stick with their treatment plan. (Learn more about how UCHealth provides medical interpreters at every appointment, at no charge)
• Health literacy is also low among Hispanic women. A total of 41% of Hispanic women are in the lowest health literacy category compared with 12% of non-Hispanic White women. A lower ability to find, understand and use information about their health limits the capacity of Hispanic women to make better informed decisions.

Why is it important for Hispanic women to get care that is culturally appropriate?

“Culturally sensitive health care improves trust, communication and medical treatment adherence,” Quintana said.

Family involvement and access to interpreters can improve health outcomes for patients. (Learn how UCHealth’s program Healthy Hearts and Minds inspires Hispanic participants to undertake healthier lifestyles and promotes access to free health screenings)

Community programs such as UCHealth´s Healthy Hearts and Minds and ‘Your Heart, Your Life Manual’/Su Corazón, Su Vida’ — developed by the National Heart, Lung, and Blood Institute — promote heart-healthy diets, physical activity, and weight management.

‘‘Hispanic women deserve to know their risk, to be screened early and to receive care that is culturally and linguistically responsive,’’ Quintana said. ‘‘This message is deeply personal to me — not only as a physician — but as the husband of a Hispanic woman and the father of a Hispanic daughter.’’

Good communication also is essential to safe and high-quality health care. It’s not just something nice to do. It can make a big difference in how well patients recover and stay healthy.

‘‘This is something I see in my clinic every day. Culturally appropriate care improves trust, communication, adherence, and preventive care use. Language access, family involvement (“familismo”) and culturally relevant education help address social determinants of health and mitigate disparities,’’ Quintana said.

Lifestyle changes work

Reducing blood pressure, weight, cholesterol levels and blood sugar all contribute to reducing the risk of heart attacks.

‘‘Protecting the heart health of Hispanic women safeguards families and future generations,” Quintana said.