Cardiovascular disease remains a leading cause of death among women in the United Kingdom, claiming more lives annually than breast cancer. New research indicates that mammograms, currently used primarily for breast cancer screening, may also provide valuable insights into women’s risk for heart disease, potentially allowing for earlier detection and intervention.

Heart disease often goes unrecognized or is misdiagnosed in women due to differences in symptom presentation compared to men. Classic signs of a heart attack—such as severe chest pain radiating down the left arm—are more commonly observed in men. Women, however, frequently experience less typical symptoms including breathlessness, nausea, fatigue, or pain in the back, neck, or jaw, partly due to hormonal influences and issues involving smaller blood vessels in the heart.

Data from a 2016 University of Leeds study covering over 500,000 heart attack patients revealed women were about 50% more likely than men to receive an incorrect diagnosis upon hospital admission. Those misdiagnosed faced a 70% higher mortality rate within 30 days, underscoring the challenges in recognizing heart disease in women. Additionally, conventional risk factors such as smoking, hypertension, diabetes, and high cholesterol fail to capture certain female-specific risks like pre-eclampsia, gestational diabetes, premature menopause, and poly-endocrine metabolic ovarian syndrome, which are not routinely considered during cardiovascular assessments.

Calcium buildup in arteries is a marker of vascular damage linked to heart attacks and strokes. While arterial calcification is classically examined in coronary arteries, calcium can also accumulate in breast arteries, visible in mammograms. Although this breast arterial calcification differs from coronary plaque calcification in location and nature, evidence shows that women with greater breast artery calcium have an elevated risk of cardiovascular events.

A recent study published in the European Heart Journal utilized artificial intelligence (AI) to automatically detect and quantify breast arterial calcification on mammograms from more than 123,500 women in the United States. Over a seven-year period, women exhibiting mild calcification had approximately a 30% increased risk of major cardiovascular events, moderate calcification was linked with a 75 to 80% higher risk, and severe calcification correlated with about a threefold increase in risk compared to those without calcification. Notably, these risk elevations persisted even after accounting for traditional cardiovascular factors, suggesting the mammogram reveals additional risk information.

Incorporating breast arterial calcification analysis into routine mammography could enable general practitioners to identify women at heightened cardiovascular risk and initiate preventive measures such as intensified blood pressure or cholesterol management. Until this approach is widely adopted by health services, other options to assess risk include coronary artery calcium scans, specialized lipid testing, and retinal imaging to detect vascular changes.

Experts emphasize that leveraging information from existing screening tools like mammograms could improve early detection of heart disease in women without necessitating additional tests. Women undergoing mammography are encouraged to inquire whether breast arterial calcification has been assessed and, if present, to discuss cardiovascular risk evaluation with their healthcare provider.