Hidden Heart Risks in Fit Women | Dr Chan Po Fun, Singapore
- Dr Chan Po Fun
- Jul 13
- 3 min read
Updated: Sep 8
Why Heart Disease Can Strike Even Fit Women
At 47, she was a half-marathon runner with a clean diet, no smoking habits, and no chronic conditions. Yet, during a routine jog, she experienced chest tightness. Initially dismissing it, she eventually sought medical attention, revealing a severe coronary blockage that necessitated an immediate stent placement. Outwardly healthy, her arteries told a different story.
This scenario is not uncommon. As a cardiologist specializing in Women's Heart Health, I frequently encounter women who appear fit but harbour hidden cardiovascular risks.
The Dangerous Assumption: “I Exercise, So I’m Safe”
While fitness is beneficial, it's not an absolute safeguard against heart disease. Many women with excellent health habits still develop cardiac conditions due to factors that are not immediately apparent.
5 Hidden Heart Risks in Fit Women
1. Lipoprotein(a): The Genetic Risk You Can’t Outrun
Lipoprotein(a), or Lp(a), is a genetically inherited cholesterol particle that increases your risk of heart attack and stroke, even if your other cholesterol levels are normal. Most women have never been tested for it because Lp(a) isn’t included in routine cholesterol panels.
✅Action: Request a one-time Lp(a) blood test, especially if you have a family history of early heart disease or stroke.
2. Autoimmune Conditions and Chronic Inflammation
Conditions like lupus, rheumatoid arthritis, psoriasis, and Hashimoto’s thyroiditis can triple your risk of cardiovascular disease due to ongoing inflammation that silently damages arteries.
✅Action: If you have an autoimmune disease, consider early cardiovascular screening - even if you feel well and stay active.
3. Visceral Fat: The “Skinny Fat” Paradox
Some lean women—especially those with a normal BMI—still carry too much visceral fat, the dangerous fat wrapped around internal organs. This fat increases your risk of insulin resistance, high blood pressure, and heart disease.
✅Action: Track your waist circumference (ideal <80 cm for women). If you’re slim but have a rounder belly or fatigue after meals, consider body composition analysis.
4. Exercise-Induced Stress and Overtraining
While regular exercise is protective, excessive high-intensity training without recovery can raise cortisol levels, cause chronic inflammation, and increase the heart’s workload—especially in women who do mpt rest adequately.
✅Action: Balance intense workouts with rest days, mindfulness practices, and heart rate variability monitoring if training heavily.
5. Menopause and Arterial Aging
During perimenopause and menopause, estrogen levels drop. This leads to stiffer arteries, higher cholesterol, and increased central fat gain. Even fit women can experience rapid cardiovascular changes in this stage of life.
✅Action: Women over 40 should have a baseline heart screening, especially during or after menopause.
Other Overlooked Heart Risk Factors in Women
Strong family history of early heart disease
History of chemotherapy or left-sided breast radiation
Chronic stress or poor sleep
High blood pressure during pregnancy (pre-eclampsia), or gestational diabetes
How to Protect Your Heart—Even If You’re Fit
Get a comprehensive heart health check-up, not just basic labs.
Ask about Lp(a) and inflammatory markers.
Don’t rely on BMI. Track waist circumference and body composition.
Rest and recover, especially if you train hard.
Don’t ignore menopause-related changes.
FAQ: Hidden Heart Risks in Fit Women
Q: What are hidden heart risks in fit women?
A: Hidden heart risks include genetic factors like lipoprotein(a), autoimmune conditions causing chronic inflammation, visceral fat despite a normal BMI, overtraining without adequate rest, and menopause-related arterial changes.
Q: How should I assess my heart health as a fit woman ?
A: Request comprehensive screenings that include tests for lipoprotein(a), inflammatory markers, and body composition analysis.
Q: Is overtraining harmful to heart health?
A: Yes, excessive high-intensity training without proper recovery can elevate cortisol levels, induce chronic inflammation, and strain the heart.
Q: How does menopause affect heart health in women?
A: Menopause leads to decreased estrogen levels, resulting in stiffer arteries, higher cholesterol, and increased central fat gain, all of which elevate heart disease risk.
Heart Screening for Fit Women in Singapore
We offer heart screenings designed specifically for women. If you’re active, health-conscious, and want clarity on your true heart risk, we’re here to help you take the next step, confidently.
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