9 Hidden Risk Factors for Heart Disease

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Depression and Irregular Periods

3. Depression
“Depression is the least-known widespread cardiac risk factor. It’s as strong a predictor as smoking in some cases,” says Sharonne N. Hayes, M.D., director of the Women’s Heart Clinic at the Mayo Clinic in Rochester, Minnesota.
           
Women are about twice as likely to suffer from depression as men. “We estimate that 20 percent of women are depressed at any given time, and about 50 percent of them are undiagnosed and untreated,” says Andrew Farah, M.D., chief of psychiatry at High Point Regional Health Systems in North Carolina. One study found that postmenopausal women with symptoms of depression but no history of heart disease had a 50 percent greater risk of developing or dying of heart disease than women without depression.
           
Depression also worsens your chances of survival once you have heart disease. In a study published in the Journal of the American Medical Association, depressed women who were hospitalized after a heart attack were three to five times likelier to die within six months. Some studies suggest you lower your heart disease risk by treating depression, but Hayes says more research is needed for a definitive answer.

Why it’s a risk factor: Depression can cause abnormal heart rhythms, elevated blood pressure, and faster blood clotting, all of which tax the heart. Also, depressed people are less likely to take care of themselves and more likely to engage in unhealthy behaviors, such as smoking. If you’re concerned about depression, talk to your doctor. Or you can take the depression screening test here.

4. You’ve always had irregular periods.
If your menstrual history is notable for unpredictable cycles, you may be at greater risk for heart disease. Menstrual irregularities arising from polycystic ovary syndrome (PCOS), which affects 5 to 10 percent of women, increase your risk. Often, PCOS isn’t diagnosed until a woman has trouble getting pregnant, and many women don’t get diagnosed at all.
 
Why it’s a risk factor: “Women with abnormal periods produce less estrogen, so they lose its protective effect of keeping coronary vessels elastic,” Mieres, of the American Heart Association, says. “Stiff arteries are just more disease-prone.” There’s another factor at work: PCOS is a chronic condition, so it keeps the immune system on high alert, creating a chronic inflammation of the whole body, and heart disease is basically an inflammatory process involving the arteries. “Inflammation is a key factor for ischemic disease, in which a heart attack is triggered by insufficient blood flow,” Mieres says.
           

Women with PCOS also are more likely to have high triglyceride levels, diabetes, or excess belly fat—all components of so-called metabolic syndrome, a potent predictor of coronary heart disease. If you have a history of irregular periods or have been diagnosed with PCOS, be sure to get your blood pressure, cholesterol, and triglyceride levels tested.