Bridging the Gap with Dr. G Season 1: Autoimmunity, Cardiovascular Health & Wellness

The Hidden Heart Risk

What Every Woman with Autoimmune Disease Needs to Know

Have You Ever Been Told...

"Your heart tests are normal."

Yet...

You still felt exhausted.

You couldn't climb stairs like you used to.

Your heart raced for no reason.

You were short of breath.

Or you simply knew something wasn't right.

I've heard this story countless times throughout my career.

Many of the women I've cared for were living with autoimmune disease.

Their symptoms were often explained away as stress.

Or aging.

Or simply "part of the autoimmune disease."

Sometimes they were.

Sometimes they weren't.

One of the most important lessons I've learned during more than three decades as a cardiologist is this:

When women tell us something has changed, we should listen.

Because sometimes the missing piece isn't found in a routine heart test.

Sometimes it's found in understanding the connection between chronic inflammation and cardiovascular health

And that's the bridge we're crossing today.

"Heart disease isn't just about cholesterol. Sometimes, it's about inflammation."

Most people think of heart disease as something that happens because of high cholesterol, smoking, diabetes, or high blood pressure.

While those are important risk factors, they don't tell the whole story.

For millions of women living with autoimmune diseases, another powerful contributor often goes unrecognized: chronic inflammation.

🩺 Did You Know?

Women with autoimmune diseases are approximately 1.5 to 2 times more likely to develop cardiovascular disease than women without chronic inflammatory disease. In lupus, the risk may be even greater, particularly in younger women. Chronic inflammation can accelerate damage to the lining of blood vessels years before symptoms appear.

That persistent inflammation doesn't stay confined to your joints, skin, thyroid, or digestive tract.

It also affects your blood vessels—and ultimately, your heart.

The Hidden Link Between Inflammation and Heart Disease

Every blood vessel is lined by an extraordinary layer of cells called the endothelium.

Think of it as Teflon® for your arteries.

When healthy...

Blood flows smoothly.

The arteries stay flexible.

Clots are less likely to form.

But chronic inflammation changes that.

The endothelium becomes irritated.

Tiny injuries develop.

Inflammatory cells move in.

Cholesterol becomes trapped.

Plaque begins to grow.

Long before symptoms ever appear.

Why Women Are Different

Heart disease in women often looks different than it does in men.

Women are more likely to develop:

• Coronary microvascular dysfunction (disease of the heart's small vessels)

• Coronary vasospasm

• Ischemia without obstructive coronary artery disease (INOCA)

• Heart failure with preserved ejection fraction (HFpEF)

These conditions may not appear on a traditional coronary angiogram, which helps explain why some women continue to experience symptoms despite being told their arteries are "normal."

When autoimmune disease is added to the picture, inflammation may further increase the risk of these conditions.

Autoimmune Diseases Associated with Higher Cardiovascular Risk

Research has shown increased cardiovascular risk in women living with several autoimmune diseases, including:

• Lupus (systemic lupus erythematosus)

• Rheumatoid arthritis

• Psoriatic arthritis

• Sjögren's syndrome

• Ankylosing spondylitis

• Inflammatory bowel disease

• Systemic sclerosis

• Multiple sclerosis

The degree of risk varies depending on the condition, disease activity, and other cardiovascular risk factors, but the overall message is consistent:

"Inflammation matters."

Symptoms You Should Never Ignore

Heart disease doesn't always announce itself with crushing chest pain.

Women may experience:

• Shortness of breath

• Unusual fatigue

• Chest pressure or tightness

• Pain in the neck, jaw, back, or shoulders

• Palpitations

• Dizziness or lightheadedness

• Reduced exercise tolerance

• Nausea associated with exertion

Because many of these symptoms overlap with autoimmune disease itself, they are sometimes dismissed or attributed solely to fatigue or a disease flare.

They deserve thoughtful evaluation.

The Good News

Having an autoimmune disease does not mean heart disease is inevitable.

Knowledge creates opportunity.

Many cardiovascular risk factors are modifiable.

Managing inflammation, controlling blood pressure, improving cholesterol when appropriate, maintaining a healthy weight, exercising regularly, prioritizing sleep, eating a heart-healthy diet, avoiding tobacco, and partnering with your healthcare team can all help reduce long-term cardiovascular risk.

Small, consistent steps often have a greater impact than dramatic short-term changes.

Bridging the Gap

For years, cardiology focused primarily on cholesterol and blocked arteries.

Today, we recognize that cardiovascular health is influenced by inflammation, metabolism, immune function, hormones, lifestyle, and the health of the blood vessels themselves.

This broader understanding is especially important for women living with autoimmune disease.

The goal isn't to create fear.

The goal is awareness.

Because when we recognize risk earlier, we have more opportunities to prevent disease before it develops.

Key Takeaway

Autoimmune diseases don't just affect the immune system—they can also affect the heart and blood vessels through chronic inflammation. Understanding that connection is the first step toward protecting your cardiovascular health.

Bridge Builder Challenge

Ask yourself these three questions:

• Do I know my blood pressure?

• Do I know my cholesterol numbers?

• Have I talked with my healthcare team about how my autoimmune disease affects my heart?

If the answer to any is "no," make it your goal to start that conversation.

Coming Next Week

Inflammation: The Silent Driver of Cardiovascular Disease

We'll explore how chronic inflammation damages blood vessels, why it accelerates atherosclerosis, and what current research tells us about reducing inflammatory risk.

Join the Conversation

Were you aware that autoimmune disease can increase the risk of heart disease? Have you ever had heart-related symptoms that were attributed solely to your autoimmune condition?

I'd love to hear your experiences and questions. By sharing our stories, we help others realize they are not alone.

Until next time…

Keep asking questions. Keep connecting the dots. Keep building your bridge to optimal health.

— Dr. G

Disclaimer: This blog is intended for educational purposes only and should not replace personalized medical

advice. If you experience chest pain, severe shortness of breath, fainting, or other emergency symptoms, seek immediate medical care.