"At What Age Should I Start Seeing a Cardiologist?"

Although heart issues are often seen as a “man’s problem,” heart disease is actually the leading cause of death for women in the US. The good news is that there is so much we can do to take care of our hearts before there’s ever a problem.

And one of those things is seeing a cardiologist.

While you don’t need to wait a certain age, there are guidelines to help you decide when to go. I spoke with Dr. Jennifer Haythe, Director of the Cardio-Obstetrics program at Columbia University, about when women should prioritize cardiovascular care and what signs to watch out for.

If You’re Above 40

Once you turn 40, start having conversations about your heart health with both your primary care doctor and OB-GYN. Why both? Because your reproductive and cardiovascular health are closely connected:

• Polycystic Ovary Syndrome (PCOS). PCOS is a hormonal disorder, but it’s linked to insulin resistance and inflammation. That can lead to a higher risk of diabetes, high blood pressure, or of LDL cholesterol.
• Menopause. Before menopause, estrogen offers some protection against heart disease. But once estrogen levels drop, the risk of heart disease increases.

Of course, we can’t forget pregnancy, which puts your cardiovascular system through a real ‘stress test’ of sorts. While pregnant, your blood volume increases by 30% to 50%, the heart works harder, and circulatory dynamics change to support a growing human.

And if there are complications during pregnancy, it can be an early warning sign of future heart issues. You’re at higher long-term risk of heart disease if you’ve had:

• Preterm Delivery: Giving birth before 37 weeks of pregnancy.
• Gestational Diabetes: High blood sugar that develops during pregnancy.
• Placental Abruption: When the placenta separates from the uterine wall before delivery.
• Pre-eclampsia: High blood pressure and protein in urine during pregnancy.

If You’re Under 40

Under 40? Then you should consider seeing a cardiologist if you have any of the following risk factors:

• Family History of Early Heart Disease: If close relatives had heart attacks or strokes before age 55 (for men) or 65 (for women), that’s your cue. The same goes for family history of genetic causes of arrhythmia or cardiomyopathy (heart failure syndromes).
• Certain Health Conditions: If you have high blood pressure, high cholesterol, diabetes (including gestational diabetes), or obesity, it’s best to get checked out, as it can put extra strain on your cardiovascular system.
• Smoking History: Whether you're a current smoker or quit years ago, tobacco use damages blood vessels and increases heart disease risk.
• Autoimmune and Connective Tissue Diseases: Conditions like lupus, rheumatoid arthritis, scleroderma, Marfan’s Syndrome, Ehlers-Danlos Syndrome, or Loeys-Dietz Syndrome can affect your heart.

How to Keep Your Heart Healthy

The best ways to keep your heart healthy are the same tried-and-true habits we covered earlier: Consistent, quality sleep, managing your stress, moving your body daily, and eating a heart-healthy diet (which includes lots of fatty fish, leafy greens, berries, nuts, and whole grains).

Bottom line: You should chat with your primary care doctor or OB-GYN about heart health by age 40, or sooner if you have risk factors or symptoms.

This question came directly from a member of the Ajenda community.

_{Dr. Haythe is the Irene and Sidney B. Silverman Associate Professor of Cardiology in Medicine, Director of the Adult Pulmonary Hypertension Program, and Director of the Cardio-Obstetrics program at Columbia University Irving Medical Center in New York City. She specializes in heart failure, cardiac transplant, pulmonary hypertension, women’s cardiovascular disease and cardio-obstetrics. Follow her on instagram@jennhaythe.}