She Ran Marathons But Needed a Stent: Hidden Heart Risks in Fit Women
- Dr Chan Po Fun
- 5 days ago
- 3 min read
Why Heart Disease Can Strike Even Fit Women
She was 47. A half-marathon runner. Clean diet. No smoking. No chronic conditions. When she felt chest tightness during a weekend jog, she nearly didn’t come in. But tests revealed a severe coronary blockage. She needed a stent—immediately.
She looked healthy. But underneath, her arteries told a different story.
This isn’t rare. As a cardiologist who focuses on women’s heart health, I see this pattern far too often: women who are outwardly fit but inwardly at risk.
The Dangerous Assumption: “I Exercise, So I’m Safe”
Fitness is a wonderful thing—but it’s not a guarantee against heart disease. In fact, many women with excellent health habits still develop cardiac disease due to factors they can’t see or feel. Fit women can have hidden heart risks.
Let’s break down the hidden risks.
🔥 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.
✅ What to do: Ask your doctor for 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
Even well-controlled conditions like:
Lupus
Rheumatoid arthritis
Psoriasis
Hashimoto’s thyroiditis
...can triple your risk of cardiovascular disease due to ongoing inflammation that silently damages arteries.
✅ What to do: If you have an autoimmune disease, advocate for 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
Heart disease
It’s often missed because the woman “looks healthy” on the outside.
✅ What to do: 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 don’t rest adequately.
✅ What to do: 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, oestrogen levels drop—leading to:
Stiffer arteries
Higher cholesterol
Increased central fat gain
Even fit women may experience rapid cardiovascular changes in this stage of life.
✅ What to do: 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.
🩺 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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