Cardiovascular disease isn’t age-biased: Today, one in five heart attack patients is younger than 40 years old, per the Cardio Metabolic Institute. And the statistics are even more concerning for women. Earlier findings suggest that women are at a higher risk of dying from heart disease, including heart attack and stroke, than men. Cardiovascular risk also “accelerates dramatically” post-menopause. But even with this information, researchers say women with cardiac issues often go undiagnosed and untreated.
This is a common theme in women who don’t exhibit the standard modified risk factors for heart disease—medically referred to as “SMuRFs”— and they’re subsequently deemed “healthy” by their doctor.
The four primary SMuRFs include hypertension, high cholesterol, diabetes, and smoking. However, the statistics don’t lie: You can be “SMuRF-Less” and still have a heart attack or stroke.
RELATED: Taking 1 Common Medicine Could Prevent 100,000 Heart Attacks A Year, Research Finds.
A blood test called hsCRP could help identify women who are at risk but fly under the radar with traditional screening methods, according to a new preventive cardiology study published in The European Heart Journal. The research was carried out by doctors from Mass General Brigham and is being presented at the 2025 European Society of Cardiology Congress.
“Women who suffer from heart attacks and strokes yet have no standard modifiable risk factors are not identified by the risk equations doctors use in daily practice,” Paul Ridker, MD, MPH, a preventive cardiologist at Mass General Brigham’s Heart and Vascular Institute, said in a press release.
“Yet our data clearly show that apparently healthy women who are inflamed are at substantial lifetime risk. We should be identifying these women in their 40s, at a time when they can initiate preventive care, not wait for the disease to establish itself in their 70s when it is often too late to make a real difference,” he continued.
The hsCRP stands for a high-sensitivity C-reactive protein test. C-reactive proteins are made by the liver, and an increased level of CRP indicates that there is inflammation in the body, explains Mayo Clinic.
“A high level of hs-CRP in the blood has been linked to an increased risk of heart attacks. Also, people who have had a heart attack are more likely to have another heart attack if they have a high hs-CRP level. But their risk goes down when their hs-CRP level is in the typical range,” notes the clinic.
For the study, the research team assessed 12,530 healthy, SMuRF-Less women. Participants completed the hsCRP blood test at baseline and were observed over the course of 30 years. A total of 973 first major cardiovascular events, including heart attack and stroke, occurred during this period.
Although relatively healthy otherwise, women were considered inflamed and at-risk for cardiac issues if their hsCRP levels were greater than 3 mg/L. (For reference, Mayo Clinic considers hs-CRP levels less than 2 mg/L as “lower risk of heart disease,” and hs-CRP levels equal to or greater than 2 mg/L as “higher risk.”)
Results showed women with high hsCRP levels had a:
- 77 percent increased lifetime risk of coronary heart disease.
- 52 percent increased lifetime risk of suffering from any major cardiovascular event.
- 39 percent increased lifetime risk of stroke.
RELATED: 85% of Unvaccinated Women Will Likely Get This Virus—And New Research Links It to Heart Disease.
However, the study authors say that statins can help lower heart attack and stroke risk by 38 percent in “SMuRF-Less but inflamed” individuals.
“While those with inflammation should aggressively initiate lifestyle and behavioral preventive efforts, statin therapy could also play an important role in helping reduce risk among these individuals,” said Ridker.
Hypertension, high cholesterol, diabetes, and smoking are the top four major risk factors for heart disease, but obesity, age, family history, poor diet, lack of exercise, and drinking can also increase your risk.
It’s important to note that heart attacks often manifest differently in women than in men. According to Johns Hopkins Medicine, common heart attack symptoms in women include pain/discomfort in the upper body, shortness of breath, lightheadedness, cold sweats, fatigue, and nausea and vomiting.
As suggested by Johns Hopkins, here are seven ways you can prevent an early heart attack:
- Maintain a healthy weight
- Follow a heart-healthy diet
- Get regular exercise
- Limit your alcohol intake
- Move throughout the day (try to avoid long periods of sitting, especially if you work at a desk)
- Manage stress
- Hace an annual checkup and stay on top of SMuRFs
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