Coronary heart disease takes years to develop, and, in the case of aduls with a vagina, it generally takes almost a decade longer to show up than it does in adults with a penis. Estrogen helps protect adults with a vagina against heart disease. It reduces the risk for heart disease until an adult with a vagina goes through menopause. After that point, the risk for heart disease in adults with a vagina is the same as that for adults with a penis.

Many people think that breast cancer is the biggest health concern for adults with a vagina. But coronary heart disease is the number one killer of adults with a vagina in the U.S. More adults with a vagina die from stroke than do adults with a penis.

Adults with a vagina have a lower chance of surviving heart attacks than adults with a penis. Studies show that more adults with a vagina die within a year of having a heart attack than adults with a penis. At older ages, adults with a vagina who have had heart attacks are more likely than adults with a penis to die from them within a few weeks.

Before menopause, many adults with a vagina seem to be protected from heart attack and stroke. This may be from the hormone estrogen. Estrogen raises HDL (“good”) cholesterol levels and lowers LDL (“bad”) cholesterol. But as adults with a vagina approach menopause, around age 50, things change. The blood cholesterol of an average an adult with a vagina begins to rise. After menopause, the risk for heart attack and stroke in adults with a vagina continues to rise with age. Loss of estrogen is a large contributor to adults with a vagina developing heart disease after menopause.

Cholesterol levels become more stable in adults with a penis around age 55. But in most adults with a vagina, both LDL and total cholesterol levels start to rise. This is because the levels of estrogen fall after menopause.

Nearly half of African-American adults with a vagina have cardiovascular disease. Only 7 out of 20 white adults with a vagina have CVD.

Smoking is the greatest single preventable cause of death. Smoking has been linked with half of all heart-related problems in adults with a vagina. For adults with a vagina, smoking is the biggest preventable risk factor for heart attack and stroke. This is also true for adults with a penis.

For adults with a vagina, smoking is the most important preventable risk factor for heart attack and stroke.

Other healthy habits are controlling high blood pressure and cholesterol levels, maintaining a healthy weight, and getting regular checkups. Many of the risks for cardiovascular diseases can be controlled by choosing healthy life habits. If adults with a vagina take control of their lives and choose habits that promote heart health, they can help prevent heart disease and stroke.

Coronary heart disease is a major risk factor for stroke.